It’s time for your annual recertification.
You must provide us with copies of your income, assets, childcare verification and medical expenses by the requested deadline. It is important to keep a working telephone number or email with HACH so we are able to reach you when needed. This process allows HACH to determine if there are any changes in your employment, income, or family members. Please carefully complete the recertification documents. The complete details about the recertification are contained in the Administrative Plan. We have outlined some of the key aspects below.
Once you receive your recertification application, the items listed below are required to process your application for continued assistance. It is recommended you obtain ALL documents BEFORE submitting your recertification packet.
If you are employed: (all family members 18 years or older)
Newly Employed - the recertification requires a letter on letterhead from your employer which verifies date of employment, hourly rate of pay and average number of hours worked each week. Also, please submit at least one (1) months’ worth of the most recent consecutive check stubs showing the wages paid to you.
Continued Employment - please provide at least one (1) months’ worth of the most recent consecutive check stubs showing the wages paid to you.
If you are no longer employed: Please provide the two (2) documents listed below if applicable:
- Please provide a statement of termination from previous employer on the former employer's letterhead indicating date of termination.
- a copy of the Unemployment Award or Benefit Letter received by the participant.
We will need at lease one (1) months' worth of statements. (please click all applicable platforms below for instructions on how to retrieve your statement)
Zelle (will be listed on your bank statement)
If you are self-employed:
- Please provide State and Federal Tax returns with W-2’s attached for the past 2 years showing amount of income.
If receiving CHILD SUPPORT:
- Provide the court decree or
- Printout from Child Support Services detailing the amount and frequency of payments.
If receiving SOCIAL SECURITY, SSI, or VA BENEFITS:(All Family Members)
Provide an award letter detailing benefits including any medical deductions for which you may be responsible.
If you are receiving STATE ASSISTANCE:
Provide SAGA budget sheet (for single families) or TANF budget sheet (for families with children).
If you have ASSETS:
Provide most recent consecutive month of Checking Account, Savings Account, pre-paid debit card, Cash app, Zelle, Venmo, Paypal statements
documents showing income from rental property, sale of property in the last 24 months, liquidation of stocks and bonds, income from interest on other investments, etc.
If paying DAYCARE that allows you to work or go to school, bring most recent months’ worth of cancelled checks or receipts and a notarized Daycare Provider Form that can be obtained from your caseworker.
A copy of your Care for Kids redetermination form if that agency is assisting with your daycare costs.
Medical for Elderly & Disabled participants only:
If you pay for all or a portion of MEDICAL bills, medical insurance premiums, prescription drugs, medical equipment or apparatus for yourself or any member of your household, bring cancelled checks, receipts, printouts from the pharmacy showing your paid share, pay stubs showing the deductions for your insurance, etc.
Photo IDs - Current photo ID for you and everyone eighteen (18) years old and older in the household.
Full-time Students - Persons 18 years of age and older who are Full Time Students will need school verification from the school.
Birth, Custody or Adoption - If you are reporting the birth, custody or adoption of a child – A copy of the actual birth certificate, social security card, and custody or adoption paperwork (Note: Birth cards/ form request for social security card will not be accepted.)
Newly Married - If you have married since the last recertification, you will need to provide a copy of your spouse’s birth certificate, social security card, marriage license, 2 recent consecutive check stubs or a letter of verification from the employer indicating their earnings. Before a spouse can be added to your assistance a criminal background check must be completed by our office.
Zero Income will be subject to verification
If you are not receiving Earned or Unearned income, Please complete the following: