[Md-sligo] info programs

Fri Jul 13 14:47:22 UTC 2012

Hi Everyone, 
Earlier this week, I send out information about programs through the
state. Today I am forwarding on where one can apply for these programs
or get more information. 
The website where one can apply for these programs is 
www.marylandsail.org 
I have posted the verification forms which are available. 

*	9701 Application for Assistance (English)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_Eng
lish_App>  

	Basic application for cash assistance, Food Stamps and Medical
Assistance programs. Includes Facts You Should Know, Application form
and Rights and Responsibilities form.

*	9701 Solicitud Para Asistencia (Spanish)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_Spa
nish_App>  

	Basic application in Spanish for cash assistance, Food Stamps
and Medical Assistance programs. Includes Facts You Should Know,
Application form and Rights and Responsibilities form.

*	9708 MA Application
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_FIA
9708-04>  

	Eligibility determination document for a child in Long Term
Care, Waiver, Kinship Care or any person under 21 not in a family.

*	OHEP Application (English)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_OHE
P_Appl_English>  

	This is the Office of Home Energy application.

*	OHEP Application (Spanish)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_OHE
P_Appl_Spanish>  

	This is the Office of Home Energy application in Spanish.

*	Food Supplement Program Reporting Guide (English)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_FS_
Change_Reporting_Guide_English>  

	This form explains reporting requirements for families in the
simplified reporting group and for those in the change reporting group.

*	Food Supplement Program Reporting Guide (Spanish)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_FS_
Change_Reporting_Guide_Spanish>  

	Guia para registrar cambios en el programa de cupones para
alimentos. This form explains in Spanish reporting requirements for
families in the simplified reporting group and for those in the change
reporting group.

*	491 FIA Change Report Form (English)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_491
_English_Change_Report>  

	Form in English for reporting changes in circumstances. 

*	491 FIA Formulario De Informe Sobre Los Cambios (Spanish)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_491
_Spanish_Change_Report>  

	Form in Spanish for reporting changes in circumstances.

*	0007 Employment Verification Form
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_let
ter_0007_employer_verification>  

	A form for an employer to complete to verify employment
information.

*	0009 Dependent Care Verification Form
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_Let
ter_0009_Dependent_Care_verification>  

	A form for the child care or other dependent care provider to
complete to verify payments.

*	0010 Insurance Verification Form
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_Let
ter_0010_Insurance_verification>  

	A form for an insurance company to use to verify insurance
coverage.

*	0011 Bank Verification Form
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_let
ter_0011_bank_verification>  

	A form to give to the bank to verify bank accounts.

*	Medical Report Form 500 (replaces 402B and 402W Medical Forms)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_Med
icalForm>  

	This form is completed by a health provider and used to
determine eligibility for federal and state programs using Social
Security disability criteria.

*	604 School Attendance Verification Form
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_Sch
ool_Form>  

	The form is completed by the parent and school official to
verify school attendance of children ages 7 - 18. This form may also be
used to verify identity for Medical Assistance programs.

*	1052 Request For Information To Verify Eligibility Form
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_105
2_English_Verification>  

	Check off form in English requesting documents to verify
eligibility for Family Investment programs.

*	1052 Pedido De Datos Para Verificar La Elegibilidad
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_105
2_Spanish_Verification>  

	Check off form in Spanish requesting documents to verify
eligibility for Family Investment programs.

*	1130 Rent and Living Arrangements Verification Form
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_Ver
f_of_Rent_and_Living>  

	This form is used to verify rent and household composition.

*	1131 Primary Prevention Initiative Health Care Form (PPI)
<https://www.marylandsail.org/SailPDFLinks/SailPDFLinks.aspx?PDF=PVF_PPI
_Health_Care_Form>  

	Form for physician to complete certifying that children and
adults receiving TCA meet PPI requirements.

If you need help please call DHR Constituent Services 1-800-332-6347 
8:00am - 5:00pm Monday - Friday. 
Martin O'Malley, Governor | Anthony G. Brown, Lt. Governor | Ted Dallas,
Secretary 
This Page Last Revised on June 21, 2012 

Contact Us <mailto:dhrhelp at dhr.state.md.us>   |   DHR Home
<http://www.dhr.state.md.us/>   |   Webmaster
<mailto:webmaster at dhr.state.md.us>   |   Accessibility
<http://www.governor.maryland.gov/accessibility.asp>   |   Privacy
Notice <http://www.dhr.state.md.us/privacy.php> 

311 West Saratoga Street, Baltimore, MD 21201  |  1-800-332-6347

Yasmin Reyazuddin 
Aging & Disability Services 
Montgomery County Government 
Department of Health & Human Services 
401 Hungerford Drive (3rd floor) 
Rockville MD 20850 
240-777-0311 (MC311) 
240-777-1556 (personal) 
240-777-1495 (fax) 
office hours 8:30 am 5:00 pm 
Languages English, Hindi, Urdu, Braille 

This message may contain protected health information or other
information that is confidential or privileged. If you are not the
intended recipient, please contact the sender by return mail and destroy
any copies of this material. 

Thank you.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://nfbnet.org/pipermail/md-sligo_nfbnet.org/attachments/20120713/ce763b5d/attachment.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: VerificationForms.jpg
Type: image/jpeg
Size: 7384 bytes
Desc: VerificationForms.jpg
URL: <http://nfbnet.org/pipermail/md-sligo_nfbnet.org/attachments/20120713/ce763b5d/attachment.jpg>