SFN 405 - Application for Assistance 430-05-100-10

(Revised 11/01/07 ML3111)

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This form is available through the Department of Human Services and may also be obtained electronically.

• Application for Assistance (SFN 405) (570kb pdf)

• Application for Assistance Guidebook (6.2 mb pdf) - contains IMPORTANT information about economic assistance programs and client rights.

 

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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.