This version of the form is not currently in use and is provided for reference only. Download this version of DSHS Form 14-076 for the current year.
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 14-076?
A: DSHS Form 14-076 is the Change of Circumstances form used in Washington.
Q: What is the purpose of DSHS Form 14-076?
A: The purpose of DSHS Form 14-076 is to report changes in circumstances that may affect eligibility for assistance programs.
Q: What changes should I report on DSHS Form 14-076?
A: You should report changes in your income, household composition, address, employment status, and other relevant information.
Q: Do I need to submit DSHS Form 14-076 regularly?
A: You need to submit DSHS Form 14-076 whenever there are changes in your circumstances that may affect your eligibility for assistance programs.
Q: Who can help me fill out DSHS Form 14-076?
A: You can seek assistance from DSHS staff or community organizations that provide support for filling out forms.
Q: What happens after I submit DSHS Form 14-076?
A: After you submit DSHS Form 14-076, your case worker will review the form and determine if any adjustments need to be made to your benefits.
Form Details:
Download a printable version of DSHS Form 14-076 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.