Mid Certification Reviews EA-Z Manual for DSHS
This manual provides guidance for mid-certification reviews for various community services programs. It details the requirements and processes for maintaining benefits during mid-certification. Ideal for case workers and clients involved in community services.
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How do I fill this out?
Filling out this form requires precise information regarding your benefits and situation. Ensure you have all relevant documents handy to provide accurate answers. Follow the provided guidelines to complete each section methodically.

How to fill out the Mid Certification Reviews EA-Z Manual for DSHS?
1
Gather all necessary documentation regarding your current income and household composition.
2
Review the instructions to understand what information is required for each section.
3
Complete the form, paying close attention to any details and requirements.
4
Submit the form before the due date to ensure no interruption in your benefits.
5
Follow up to confirm that your submission has been processed.
Who needs the Mid Certification Reviews EA-Z Manual for DSHS?
1
Individuals receiving cash assistance who need to verify changes in their circumstances.
2
Families requiring ongoing Basic Food benefits to maintain their eligibility.
3
Students who are balancing their studies with financial aid applications.
4
Caseworkers who are managing clients' benefits and need to ensure accuracy.
5
Anyone transitioning from one benefit program to another that requires a review.
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What are the instructions for submitting this form?
To submit this form, make sure all fields are accurately filled and required documents are attached. You can submit the form via email at benefits@dshs.wa.gov or send it by fax to 360-725-1234. Physical submissions can be mailed to DSHS, Community Services Division, Mail Stop 45440, Olympia, WA 98504.
What are the important dates for this form in 2024 and 2025?
In 2024, ensure all mid-certification reviews are submitted by the designated deadlines each month. This ensures continued eligibility for benefits. For 2025, stay updated on any changes in program requirements or deadlines.

What is the purpose of this form?
The purpose of this form is to facilitate the review process for ongoing benefits under community service programs. By providing accurate and updated information, individuals ensure they remain eligible for necessary assistance. This process is vital for ensuring that service recipients receive the support they rely on.

Tell me about this form and its components and fields line-by-line.

- 1. Income: Current income from all sources.
- 2. Household Composition: Details about all members living in the household.
- 3. Benefits Status: Information regarding existing benefits being received.
- 4. Deductions: Applicable legal deductions from income.
- 5. Address: Current residential address of the applicant.
What happens if I fail to submit this form?
Failing to submit this form will result in a review delay and potential benefits termination. It is crucial to submit all required information to avoid interruption.
- Loss of Benefits: Without timely submission, you may lose eligibility for benefits.
- Increased Scrutiny: Repeated failures to submit can lead to closer monitoring by service agencies.
- Additional Forms Required: Lack of submission may lead to requests for additional documentation and forms.
How do I know when to use this form?

- 1. Change in Employment: Report any changes in employment status or income.
- 2. Household Changes: Update any changes in household members or composition.
- 3. Deductions Update: Notify of any changes in legal deductions, like child support.
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