SFN 827, Credit Form 400-28-165-60

(Revised 8/1/2023)

View Archives

 

 

SFN 827, Credit Form is used by eligibility workers to submit payments to the State Office.

 

This form is available through the Department of Health and Human Services and may also be obtained electronically via E-Forms.

 

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.