3/24/2024 0 Comments Nc food stamp application onlineDoes anyone in your household work? Yes No If yes, complete below. Please answer these questions about any activity within the last 6 months. ***These questions may assist in identifying Able-Bodied Adults without Dependents (ABAWD). **Race Choose one or more numbers that apply and enter above: 1-American Indian/Alaskan Native, 2-Asian, 3-Black/African American, 4-Native Hawaiian/Other Pacific Islander and 5-White Giving this information will help ensure program benefits are distributed without regard to race, color, or national origin (this information is used for statistical purposes only). When the information is not provided the agency will collect the information by observation during the interview. Eligibility or level of benefits are not affected if ethnicity or race is not answered. *Giving your ethnicity and race information is voluntary and may be protected by the Privacy Act. *Social Security Numbers and Citizenship information are not needed for those not applying for benefits. The amount of benefits will depend on the number of people requesting benefits.Ī. Eligible household members who apply will be able to get benefits even though some people in the household are not applying for benefits. Household members must provide their financial information because it is needed to determine eligibility for individuals who are applying. By signing this form, it states, under penalty of perjury I have given correct information on the citizenship/alien status of all individuals applied for. If an applicant does not provide this information, they will be ineligible for benefits. We will only contact US Citizenship and Immigration Service (USCIS) to check the immigration status on the household members who give us their immigration documents. You must be a United States (U.S.) citizen or an eligible alien and also meet other Food and Nutrition Services rules to get Food and Nutrition Services benefits. We will only use the SSNs you give us to do computer matches and check what you told us with State and Federal Agencies. Providing an SSN is required by the Food and Nutrition Act for applicants seeking benefits. If you do not want to answer questions about SSNs or citizenship/immigration status, you may choose not to apply. Information about Social Security Numbers, US Citizenship and Immigrationįor everyone that you are applying for, you must provide information about Social Security Numbers (SSNs) and citizenship/immigration status. Attach verifications for the month of _.Do not return this form before the first day of _.Please make sure the address of the local agency shows through the window of the enclosed return envelope.The information on this form and information obtained from other sources may cause your benefits to stop or change. You are responsible for providing required verification information. If a signed form is incomplete, your FNS worker will contact you to get more information. If you are a resident of an institution and are applying for both Supplemental Security Income (SSI) and FNS benefits prior to leaving the institution, the filing date of the application is the date you leave the institution. Any household that only has Supplemental Security Income (SSI) can apply for recertification at the Social Security office. To us at the above address, fax or complete application online. If you cannot complete this form you will only need to provide a signature, legible name, and address. You have the right to receive an application upon request. You or your authorized representative must complete this entire form, sign and date the last page. You may be able to continue to get FNS benefits after that date if youįill out this form and return it to us no later than_. If you have a disability and need communication assistance, call 1-86 or Relay Services:711. After the recorded message, you will reach an operator whoĬan provide you with an interpreter. To receive free interpreter services, call 1-86 or call your local DSS office at _. Free language assistance and/or other aids and services are available upon request. Please tell us if you need assistance because you do not speak English or have a disability. North Carolina Department of Health and Human Servicesįood and Nutrition Services (FNS) Notice of Expiration and Recertification Form Landlord (Tenant) Recommendation LetterĬase Identifier: _.
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