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  • Assistance Application (MDHHS-1171) - State of Michigan
    The MDHHS-1171 contains an application for assistance and program specific supplement forms Be sure to read the information booklet before you sign the Assistance Application
  • 1171 - Wikipedia
    1171 King Henry II arrives at Waterford Year 1171 (MCLXXI) was a common year starting on Friday of the Julian calendar
  • MDHHS-1171 Assistance Application and Program Supplements
    We need a Social Security number (SSN) for people who are requesting assistance and have a SSN or can get one See Info Booklet (Pg 32) for more details My monthly income is less than $150 and I have $100 or less in cash accounts right now
  • MDHHS-1171 Assistance Application, Program Supplements and Information . . .
    We need a Social Security number (SSN) for people who are requesting assistance and have an SSN or can get one See Info Booklet (Pg 30) for more details My monthly income is less than $150 and I have $100 or less in cash accounts right now
  • DHS-1171, Assistance Application
    Destitute means that your income stopped before the date you applied, or your income has started but you expect to receive no more than $25 within the next 10 days
  • MDHHS-1171 (10-24) - State of Michigan
    Answer questions about you and your household You will need to interview with a MDHHS specialist, unless applying for healthcare coverage only www michigan gov mibridges Refer to the Information Booklet for details on each program What language do you prefer?
  • Assistance Application - State of Michigan
    Y N Y N Name: Individual ID #: MDHHS-1171-FAP (Rev 10-24) Previous edition obsolete Cash Assistance Fill out the following details along with the Assistance Application if seeking Cash Assistance Is anyone in the household
  • MDHHS-1171 Assistance Information Booklet - State of Michigan
    We need a Social Security number (SSN) for people who are requesting assistance and have a SSN or can get one See Info Booklet (Pg 32) for more details My monthly income is less than $150 and I have $100 or less in cash accounts right now
  • APPLICATION PROCESSING - Michigan
    When the need for retroactive coverage, including specific months, is indicated on the DCH-1426, DHHS 1171, Healthcare coverage supplement, or MI Bridges, a separate DHS-3243 is not required
  • APPLICATION FILING AND REGISTRATION
    The MDHHS-1171 packet includes an information booklet, the assistance application, and program specific supplement forms A filing form used to preserve the application filing date for programs other than Medicaid, is available in the MDHHS-1171 and online at www michigan gov dhs-forms





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