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Fingerprint Appointment Use this form to assist in scheduling a Department of Social and Health Services fingerprint appointment. Section 1: To be completed by the requesting agency 1. The agency
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How to fill out dshs 27 059 form
How to fill out dshs 27 059?
01
Complete the personal information section, including your name, address, phone number, and social security number.
02
Provide information about your household, including the names and relationship of the people living with you, their social security numbers, and any income they receive.
03
Answer the questions regarding your eligibility for benefits accurately and truthfully.
04
Provide details about your current living situation, including your rent or mortgage payments and any utilities you pay.
05
If applicable, fill out the section regarding your medical expenses, including any doctors' visits, prescriptions, or other healthcare costs.
06
Sign and date the form, certifying that the information provided is true and complete.
Who needs dshs 27 059?
01
Individuals who are applying for or receiving state assistance programs, such as Temporary Assistance for Needy Families (TANF) or Medical Assistance.
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Those who are seeking financial aid for housing, childcare, or other basic needs.
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Individuals who require assistance with their medical expenses, such as prescriptions or doctor visits.
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