Forms

HHS forms are used every day to perform tasks such as applying for benefits, contracting to provide goods or services, reporting incidents, declaring end of life wishes, and conducting other business.

ES = Spanish version available.

Title
Form H1846, Facility Authorized Representative Interview
Form H1847, Reminder to Submit Form H1852
Form H1851, Reference Guide for Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities
Form H1853, Documentation of Findings for Form H1852
Form H1854, Affidavit for Unauthorized Use of Electronic Benefit Transfer (EBT) Benefits
Form H1856, SNAP Out-of-State Intentional Program Violations
Form H1857, Landlord Verification ES
Form H1858, Items We Might Need from Anyone on Your Case ES
Form H1870, School Enrollment Verification Form ES
Form H1898, Restored Benefits Documentation
Form H1899, Unauthorized Use Replacement Benefit Eligibility Notice
Form H2580, TANF Employment Services Notice
Form H2583, Choices Information Transmittal
Form H2588, Workforce Orientation Referral
Form H2776, Job Search Worksheet for TANF Employment Hardship Exemption ES