DSHS Form 10-377 SM Notification of Age Four (4) Eligibility Expiration - Washington (Somali)

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.

The document is provided in Somali. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 10-377 SM?
A: DSHS Form 10-377 SM is a notification form related to age four (4) eligibility expiration in the state of Washington (Somali version).

Q: What is the purpose of DSHS Form 10-377 SM?
A: The purpose of DSHS Form 10-377 SM is to notify individuals about the expiration of eligibility for certain services at the age of four (4).

Q: Who is required to fill out DSHS Form 10-377 SM?
A: Parents or legal guardians of children who are nearing the age of four (4) and are receiving services that might be affected by eligibility expiration need to fill out this form.

Q: What services might be affected by eligibility expiration?
A: Services that might be affected by eligibility expiration include medical coverage, food assistance, and other programs provided by the Washington State Department of Social and Health Services (DSHS).

Q: Is there a deadline for submitting DSHS Form 10-377 SM?
A: Yes, there is a deadline for submitting DSHS Form 10-377 SM. It is important to submit the form before the child's fourth birthday to ensure continuity of services.

Q: What happens if I don't submit DSHS Form 10-377 SM on time?
A: If you fail to submit DSHS Form 10-377 SM on time, your child's eligibility for certain services may expire, and they may no longer be eligible for the benefits provided by those programs.