Massachusetts Department of Transitional Assistance Forms

This document is used for sending electronic documents via mail or fax in Massachusetts.

This form is used for requesting verification from a landlord in Massachusetts.

This document is an application form specifically designed for seniors in Massachusetts. It is used for enrolling in various senior citizen benefit programs or accessing resources and services specifically tailored to the needs of the elderly population in the state.

This type of document is a cover sheet for mail/fax for the Electronic Document Management (EDM) of the Department of Transitional Assistance (DTA) in Massachusetts.

This form is used for requesting permission to share personal information in the state of Massachusetts.

This Form is used for selecting someone as an authorized representative in Massachusetts.

This Form is used for Massachusetts residents to request an agency employee to be their authorized representative for SNAP benefits.

This Form is used for obtaining voluntary consent to release information in Massachusetts.

This document is used for obtaining voluntary consent to disclose personal information in Massachusetts.

This form is used for applying for Emergency Aid to the Elderly, Disabled and Children Disability Supplement in the state of Massachusetts.

This document is for providing feedback or comments from customers in Massachusetts. (Spanish language)

This form is used for individuals in Massachusetts to provide a statement explaining the medical reasons that prevent them from meeting the requirements of the Transitional Aid to Families with Dependent Children (TAFDC) program.

This form is used for applying for the Transitional Aid to Families with Dependent Children Disability Supplement (TAFDC-DS) in Massachusetts. It provides additional financial assistance to families with dependent children who have a disability.

This Form is used for authorizing reimbursement of interim assistance for initial claims or posteligibility cases in Massachusetts.

This Form is used for residents of Massachusetts to request the selection of someone as their authorized representative.

This document is used in Massachusetts for reporting medical information related to work requirements for the SNAP program. It helps determine eligibility for food assistance benefits.

This document is a form used to request that an employee of the agency be appointed as an authorized representative for SNAP benefits in Massachusetts.

This form is used for Massachusetts residents to request replacement SNAP benefits in cases of household disaster or misfortune.

This document is used for certifying shelter and utility costs by another agency in Massachusetts.

This form is used for residents of Massachusetts to apply for replacement of SNAP benefits due to a disaster or unfortunate event in their home. (Spanish version)

This form is used to request permission from individuals in Massachusetts to share their information.

This Form is used for requesting reimbursement for temporary assistance in Massachusetts. It is used for initial claims or post-eligibility cases.

This Form is used for collecting feedback from clients in Massachusetts.

This form is used for verifying that someone is caring for a disabled individual in Massachusetts for the purpose of receiving TAFDC benefits.

This Form is used for reporting educational income and expenses in Massachusetts.

This form is used for submitting a medical report in Massachusetts.

This document is used to fulfill the medical report requirement for the Abawd Work Program in Massachusetts.

Este formulario es utilizado para solicitar el beneficio por funeral y descanso final en Massachusetts. Con este formulario, las personas pueden solicitar asistencia financiera para cubrir los gastos de funeral y descanso final de un ser querido.

This Form is used for applying for the Funeral and Final Disposition Benefit in Massachusetts. It allows individuals to seek financial assistance for funeral expenses in the state.