Who needs an LDSS-2921 form?
This form is used to apply for public assistance. It’s completed by the person who needs any kind of assistance or benefits. This form allows applicants to apply for temporary assistance, food stamps, home energy assistance, medical or other services, and/or child care assistance.
What is the purpose of the LDSS-2921 form?
This form is an application for different assistance programs: medical assistance; medicare savings program; food stamps benefits; temporary assistance; services, including foster care; child care; emergency payment. The information provided in the form is used by the SSA to determine the eligibility for benefits according to a certain program.
What documents must accompany the LDSS-2921 form?
This form must be accompanied by other documents if there is a need.
How long does it take to fill the form out?
The estimated time for completing the form is two hours. The application is filled out when there is a need.
Which parts should be filled in the application?
The application contains several parts to be filled out (corresponding to the applicant’s case). These are the following:
-
Some information about the required assistance program
-
Information about the applying person and non-applicants
-
Immigration information
-
Non-custodial parent/child support/medical support information
-
Absent/ deceased spouse information
-
Teen parent information
-
Income information
-
Step-parent/immigrant sponsor information
-
Employment information
-
Education/training
-
Resources information
-
Medical information
-
Home (landlord’s name, address and phone number)
-
Additional information (child support, alimony, child care, dependent care,
The applicant should keep in mind that the application will be investigated.
The completed form is signed and dated by the person applying for benefits or somebody on his/her behalf.
What do I do with the LDSS-2921 form after its completion?
The completed and signed form is forwarded to the local social services of your town. This form is used in all states of the USA.