Application 430-05-20-15

(Revised 11/01/04 ML2941)

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An SFN 405 - Application for Assistance is considered incomplete if it contains only the applicant's name, address and signature of a responsible household member or authorized representative.  The household must be advised that it does not have to be interviewed before filing the application and may file an incomplete application form.  

 

An SFN 405 - Application for Assistance is considered a completed application if it contains the applicant's name, address, household composition, income, assets, the signature of the applicant, responsible household member or authorized representative.

 

The date of application is the date the county receives a signed SFN 405 – Application for Assistance.  The date of application for a faxed Application for Assistance is the date the county receives it.  If a faxed Application for Assistance is received on a weekend or holiday, the date of application is the next working day.  The county must document the date an application is filed by recording the date it was received on the application.

 

For residents of institutions who apply prior to release, the date of application is the date of the release.

 

An individual’s signature on the application attests to providing full information and to understanding the reporting requirements of the program.