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OR DHS 0415F 2020-2025 free printable template

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Print formulae form SELF-SUFFICIENCY PROGRAMSApplication for ServicesWhat do I need to do to get benefits? 1. Pick up an application (DHS 0415F). You can get an application by: Printing one from https://apps.state.or.us/Forms/Served/de0415F.pdf; Calling
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Obtain the OR DHS 0415F form from the appropriate agency or website.
02
Carefully read the instructions provided on the form.
03
Fill in your personal information, including your name, address, and contact details in the designated areas.
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Provide any necessary identification or documentation as required by the form.
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Answer all questions honestly and thoroughly, ensuring that all sections are completed.
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Review the form for any errors or omissions before submission.
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Submit the completed form to the designated office or agency, either in person or electronically, as instructed.

Who needs OR DHS 0415F?

01
Individuals applying for assistance or services from the Oregon Department of Human Services.
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Parents or guardians completing forms for child services or welfare.
03
Employees or volunteers working in facilities requiring documentation for their services.
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Anyone needing to provide information related to health or social services in Oregon.

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The Oregon Trail Card is Oregon's Electronic Benefits Transfer (EBT) c​ard. It is used for state benefits including SNAP food benefits and TANF cash benefits. It works like a debit car​​d from a bank. Benefits are deposited into your account each month.
You can also get cash from at an ATM. Your cash benefits account will be charged 85 cents for each withdrawal from an ATM. Some ATMs may charge you another fee as well.
Who is eligible for this program? Household Size*Maximum Income Level (Per Year)1$18,9542$25,6363$32,3184$39,0004 more rows
Use a POS machine to buy food with your SNAP benefits or to use cash benefits. Please note that you cannot get cash back on SNAP purchases.
pay stubs for the last 30 days, unemployment letter, court order [or letter from Family Court] verifying amount of child support, income tax return for self-employed persons only, social security, disability, pension). Proof of child care expenses.

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OR DHS 0415F is a form used by the Oregon Department of Human Services to collect information related to financial and social services.
Individuals or organizations that are applying for or receiving certain benefits and services from the Oregon Department of Human Services are required to file OR DHS 0415F.
To fill out OR DHS 0415F, provide personal identification information, detail income sources, report household size and composition, and disclose any other relevant financial information as guided in the form instructions.
The purpose of OR DHS 0415F is to assess eligibility for various state assistance programs and to ensure that the information provided is accurate and up-to-date.
The information that must be reported includes personal identification details, income details, household composition, assets, and any other relevant financial information as required by the Oregon Department of Human Services.
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