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MI DHS-1514 2018-2025 free printable template

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You may fill out the voter registration application form in private. If you believe that someone has interfered with your right to register to vote decline to register to vote privacy in deciding whether to register or in applying to register to vote or choose your own political party or other political preference you may file a complaint with Michigan Secretary of State PO Box 20126 Lansing MI 48901-0726. Case Name Case Number Date APPLICATION FOR STATE EMERGENCY RELIEF MDHHS Office /...
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How to fill out dhs emergency michigan form

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How to fill out MI DHS-1514

01
Obtain the MI DHS-1514 form from the Michigan Department of Health and Human Services website or your local office.
02
Start by filling out your personal information at the top of the form, including your name, address, and contact details.
03
Provide information about your household members, including their names, dates of birth, and relationship to you.
04
Indicate your income details, including sources and amounts, for all household members.
05
Complete the section related to expenses, including rent/mortgage, utilities, and other necessary costs.
06
Answer all questions related to your household's assets and resources.
07
Review the form for accuracy and completeness to ensure all necessary information is provided.
08
Sign and date the form at the designated area.
09
Submit the completed form to your local MI DHS office either by mail or in person.

Who needs MI DHS-1514?

01
Individuals or families seeking assistance or support from the Michigan Department of Health and Human Services.
02
Those applying for state assistance programs, such as food assistance, cash assistance, or medical assistance.
03
Residents of Michigan who need to report their income and household situation for eligibility determination.

Who uses the Form DHS-1514?

A resident of the State of Michigan might find himself in an emergency situation where he is constrained to ask for assistance. For instance, if a person fails to pay mortgage, electricity bills, property taxes, homeowner’s insurance etc. he should use the DHS-1514 to apply for help to the

The Michigan Department of Health and Human Services (MD HHS).

To qualify for State Emergency Relief, the applicant must meet certain requirements. In general, eligibility is based on the number of individuals in the applicant’s household, his monthly income and countable cash assets over $50 (except for those who apply for burial services). Some assets are excluded, for example, homestead, one vehicle, household and personal goods.

What is the purpose of the DHS-1514?

The Form DHS-1514 is an application for State Emergency Relief (SER) that covers the following services:

  • Relocation payments to eliminate or avoid homelessness;
  • Mortgage, insurance or property tax payment, to stop forfeiture, foreclosure or tax sale;
  • Limited home repairs;
  • Electric and utility bills, home heating; and
  • Burial costs.

What documents must accompany the Form DHS-1514?

The applicant must attach documents confirming the circumstances that forced him to apply for assistance.

When is the DHS-1514 due?

An application for burial assistance must be made no later than 10 business days after the burial, cremation or donation takes place.

What information should be provided?

The applicant provides the following information:

  • Household address and contact information;
  • Information about home heating;
  • Emergency need (the applicant should check the respective box and specify the amount he needs);
  • Household vehicles;
  • Household assets;
  • Household income;
  • Current housing expenses;
  • Household information for the past six months (number of people in home, total monthly income, rent/mortgage amount, heat, electricity, water, sewer and cooking gas);
  • Home expenses.

Where do I send the DHS-1514?

You can submit your application to the MD HHS office or apply online at https://www.michigan.gov/mdhhs/

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Migrant families with children may have the cost of hospitalization covered under State Emergency Relief (SER), within certain limits, for up to thirty (30) days in a one-year period.
You can renew your benefits online with a MI Bridges account. If you'd rather renew in person, call your caseworker, local office, or the Michigan SNAP hotline (1-855-275-6424) to find out how.
Nationwide, Medicaid beneficiaries will have to renew their coverage starting this year to comply with federal legislation. In Michigan, annual renewals will begin again in June 2023.
To apply for SER, submit an application to the Michigan Department of Health and Human Services (MDHHS). The application process takes around 10 days to complete. One way to apply is online through the MDHHS website, MI Bridges.
A federal program which helps persons admitted into the U.S. as refugees to become self-sufficient after their arrival.
State Emergency Relief (SER) Program. Michigan's Women, Infants & Children program, providing supplemental nutrition, breastfeeding information, and other resources for healthy mothers & babies. Information on the Family Independence Program, State Disability Assistance, SSI, Refugee, and other cash assistance.
Migrant families with children may have the cost of hospitalization covered under State Emergency Relief (SER), within certain limits, for up to thirty (30) days in a one-year period.
You can have Customer Service mail you a card, but you'll have to wait 3 to 5 business days to receive your replacement card in the mail. Or, you can also go into your WIC Clinic to request a replacement card and receive a card that day. How do I take care of my Michigan WIC Bridge Card? card.
One way to apply is online through the MDHHS website, MI Bridges. However, if you need immediate help you can also apply in person at your local MDHHS office. Your local MDHHS office will give you an application form, but it may be easier to print an application form and fill it out completely before going to MDHHS.
MDHHS will either approve or deny your application within 30 days unless you qualify for expedited services.
Eligibility Requirements for State Emergency Relief (SER) The emergency must threaten health and safety. The emergency must not have been caused by the individual or family seeking assistance. The emergency must be resolved by the assistance payment and must be one that is not likely to arise again.
Who Is Eligible? Up to $25,000 Grant Per Household to Pay: Delinquent mortgage/housing expenses, including property tax and insurance escrow shortages. Delinquent land contract payments, mobile home consumer loan payments or mobile home park lot payments.

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MI DHS-1514 is a form used by the Michigan Department of Health and Human Services to report certain financial and personal information for qualifying individuals and families applying for or receiving public assistance benefits.
Individuals and families applying for or receiving assistance benefits in Michigan, such as food assistance, cash assistance, or medical assistance, are required to file MI DHS-1514.
To fill out MI DHS-1514, individuals should provide accurate and complete information regarding their income, expenses, household members, and any other required details. It is important to follow the instructions provided with the form and ensure all necessary documents are attached.
The purpose of MI DHS-1514 is to collect necessary information to determine eligibility for public assistance programs and to ensure that benefits are distributed correctly and fairly.
MI DHS-1514 requires reporting of personal information such as household composition, income sources and amounts, expenses, assets, and other relevant details that can impact eligibility for assistance programs.
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