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

DSHS Form 10-377 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?
A: DSHS Form 10-377 is the Notification of Age Four (4) Eligibility Expiration form.

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

Q: Who is eligible to receive DSHS Form 10-377?
A: Parents or guardians of children who are approaching their fourth birthday and have been receiving certain benefits through the Washington State Department of Social and Health Services (DSHS) are eligible to receive DSHS Form 10-377.

Q: What benefits are affected by DSHS Form 10-377?
A: DSHS Form 10-377 affects certain benefits provided by the Washington State Department of Social and Health Services (DSHS), which may include medical coverage, food assistance, and cash assistance.

Q: Is DSHS Form 10-377 specific to the Somali community in Washington?
A: Yes, DSHS Form 10-377 is available in Somali and is intended to provide information to the Somali community in Washington.

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Form Details:

  • Released on October 1, 2019;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of DSHS Form 10-377 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

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

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