SFN 150, "60-Month Lifetime Exemption Background Report" 400-19-165-15

(Revised 6/1/10 ML #3218)

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SFN 150, 60-Month Lifetime Exemption Background Report form is used to submit a request to exempt a household from the 60-month lifetime limit. The form plus information to substantiate the request must be submitted to the State Exemption Determination Team (SEDT) for a final decision.

 

This form is available through the Department of Human Services and may also be obtained electronically via E-Forms. (53kb pdf)

 

E-Forms are presented in Adobe Acrobat and require the Adobe Acrobat reader. If you do not currently have Adobe Acrobat reader installed, you may download a free copy by clicking the Get Adobe Reader icon below.