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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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 (MDHHS).

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 MDHHS office or apply online at

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