DSHS Form 01-110A Protective Payee Periodic Social Services Report - Washington

DSHS Form 01-110A Protective Payee Periodic Social Services Report - Washington

What Is DSHS Form 01-110A?

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.

FAQ

Q: What is DSHS Form 01-110A?
A: DSHS Form 01-110A is a Protective Payee Periodic Social Services Report form used in Washington.

Q: What is the purpose of DSHS Form 01-110A?
A: The purpose of DSHS Form 01-110A is to report on the ongoing need for a protective payee for an individual receiving social services.

Q: Who is required to fill out DSHS Form 01-110A?
A: The protective payee is required to fill out DSHS Form 01-110A.

Q: What information is required on DSHS Form 01-110A?
A: DSHS Form 01-110A requires information about the individual receiving social services, their income, expenses, and any changes in their circumstances.

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Form Details:

  • Released on February 1, 1999;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DSHS Form 01-110A 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 01-110A Protective Payee Periodic Social Services Report - Washington

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