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Food stamp application alabama3/9/2024 If you want to appoint someone for this, write his/her name here:_ You are still responsible for the information that anyone acting as your authorized representative gives, including any information that may be incorrect. This person should know your household’s situation well enough to give any information needed to determine your eligibility for food stamps. You may appoint someone outside your household to act for your household to make an application and to be interviewed. (Use another sheet of paper to add other people if there is not enough room for everyone here.) List any other people who live in the same house with you but you do not want included in your food stamp household because they do not purchase and prepare food with you. We will tell you what we need to finish your application during your interview. Some of the things you should bring to your interview include: proof of identity( driver’s license, birth certificate), check stubs, proof of unearned income ( child support, social security, or SSI), rent receipts, medical bills, bank statements, and day care receipts. Verification of information about all household members may be required. Answer all questions for each household member. Your spouse and any children under age 22 must be included with you in your household. List everyone in your household that you are asking to get food stamps benefits for. I certify under penalty of perjury that my answers to all questions about each household member, including those about citizenship or alien status, are correct and complete. ♦ Do not give false information or hide information to get or continue to get food stamps. ♦ Do not use someone else’s food stamp benefits, identification card or EBT card for your household. ♦ Do not trade or sell food stamp benefits or EBT cards. There are also penalties if any household member is found guilty of using food stamp benefits to purchase illegal drugs or firearms. Subject to prosecution under other applicable federal and state laws. Any member who breaks any of the rules on purpose can be barred from the Food Stamp Program for one year to permanently, fined up to $250,000, imprisoned up to 20 years or both. The Social Security numbers for all household members will be used in computer matches with other agencies in determining eligibility for food stamps. You must provide true and complete information about everyone in your household and you must provide documents to prove what you say if you are asked to by the worker. When your household receives food stamp benefits, you must follow all the rules. Penalty Warnings, Perjury Statement and Signature To file a complaint of discrimination, write: USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, religion, political beliefs, or disability. If yes, answer these questions: Did all of your household income stop recently? Yesĭoes anyone in your household expect to receive income from a new source this month? Is anyone in your household a migrant or seasonal farm worker? Yes No What is your current monthly rent/mortgage payment? $_Utilities other than phone? $_Ĥ. What is the total amount of income you expect your household to receive this month? _ģ. How much money do the members of your household have in cash or a bank account? $_Ģ. You may get food stamps benefits within 7 calendar days if: your food stamp household has less than $150 in monthly gross income and liquid resources such as cash, checking or savings accounts are less than or equal to $100 or your rent/mortgage and utilities are more than your household’s combined monthly income and liquid resources or Ī member of your household is a migrant or seasonal farm worker.ġ. You will receive benefits from the date we received your signed application if you are determined eligible. We will interview you to decide if you are eligible. To file an application, you need only complete your name, address, and signature, and turn this form into the county Food Stamp Office where you live. You have the right to file an application the same day you contact the Food Stamp Office.
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