PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form DHS-4005-ENG
for the current year.
Form DHS-4005-ENG Telephone Equipment Distribution Program Application - Minnesota
What Is Form DHS-4005-ENG?
This is a legal form that was released by the Minnesota Department of Human Services - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DHS-4005-ENG?
A: Form DHS-4005-ENG is an application for the Telephone Equipment Distribution Program in Minnesota.
Q: What is the Telephone Equipment Distribution Program?
A: The Telephone Equipment Distribution Program provides free or discounted telecommunications equipment to eligible individuals with disabilities.
Q: Who is eligible for the Telephone Equipment Distribution Program?
A: Individuals with disabilities who live in Minnesota and have difficulty using standard telephone equipment due to their disability may be eligible for the program.
Q: What type of equipment is provided through the program?
A: The program provides a variety of telecommunications equipment, including amplified phones, captioned phones, and TTY machines.
Q: How can I apply for the Telephone Equipment Distribution Program?
A: To apply for the program, you need to complete and submit Form DHS-4005-ENG, the application form for the Telephone Equipment Distribution Program in Minnesota.
Q: Is there a fee to apply for the Telephone Equipment Distribution Program?
A: No, there is no fee to apply for the program.
Q: What supporting documentation is required for the application?
A: You may need to provide documentation of your disability, such as a letter from a healthcare professional, along with your application.
Q: What happens after I submit my application?
A: After you submit your application, it will be reviewed by the Minnesota Department of Human Services, and you will be notified of the decision.
Q: Is there a time limit for applying to the Telephone Equipment Distribution Program?
A: There is no specific time limit for applying to the program, but applications are processed on a first-come, first-served basis.
Form Details:
- Released on November 1, 2021;
- The latest edition provided by the Minnesota Department of Human 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 fillable version of Form DHS-4005-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.
Download Form DHS-4005-ENG Telephone Equipment Distribution Program Application - Minnesota
1
2
3
4
5
6
7
8
