Get Link Illinois Redetermination Form

Get Link Illinois Redetermination Form

The Link Illinois Redetermination form is a crucial document used by residents of Illinois to maintain their eligibility for various assistance programs, including SNAP and TANF. This form must be completed accurately and submitted by the specified due date to ensure continued benefits without interruption. To fill out the form, please click the button below.

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The Link Illinois Redetermination form serves as a crucial document for individuals and families seeking to maintain their eligibility for essential benefits, such as Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) cash assistance. This form must be completed and returned by a specified due date to ensure that benefits do not lapse. Applicants are required to provide detailed information about all household members, including their names, birth dates, and relationships, which is essential for the assessment of household composition. Additionally, the form inquires about income sources, employment status, and any changes in health insurance or address, as these factors can significantly impact benefit eligibility. Applicants must also report any recent income from various sources, such as child support or unemployment, and disclose details about housing costs, utility payments, and childcare expenses. Completing the form accurately and thoroughly is vital, as a signature is required to validate the application. Missing or incomplete information could lead to delays or denials in receiving much-needed assistance. Understanding the requirements and implications of the Link Illinois Redetermination form can empower individuals to navigate the process effectively and ensure continued support for their families.

Document Breakdown

Fact Name Details
Purpose of the Form The Link Illinois Redetermination form is used to determine ongoing eligibility for SNAP and TANF benefits in Illinois.
Submission Deadline Applicants must return the completed form by the specified due date to avoid interruption of benefits.
Income Reporting Requirement Individuals must report all income sources, including wages, child support, and other benefits, to maintain eligibility.
Governing Law This form is governed by the Illinois Public Aid Code, which outlines the regulations for public assistance programs.

Common PDF Forms

Misconceptions

Here are ten common misconceptions about the Link Illinois Redetermination form, along with clarifications to help you understand the process better.

  • Misconception 1: You don’t need to fill out the form if your circumstances haven’t changed.
  • Even if nothing has changed, you still need to submit the form to continue receiving benefits.

  • Misconception 2: The form can be submitted without a signature.
  • A valid application requires a signature. Without it, your application cannot be processed.

  • Misconception 3: You can submit the form anytime before your benefits end.
  • It’s crucial to return the form by the specified due date to avoid a lapse in benefits.

  • Misconception 4: You don’t have to report income if it’s informal or under the table.
  • All income must be reported, regardless of how it is earned. This includes tips and informal work.

  • Misconception 5: You can skip questions if you think they don’t apply to you.
  • It’s best to answer every question to ensure your application is complete and accurate.

  • Misconception 6: If you miss the due date, you can still apply later without consequences.
  • Missing the due date may result in a loss of benefits, so it’s important to stay on track.

  • Misconception 7: You don’t need to provide proof of income if you report it.
  • Documentation, such as pay stubs, is necessary to verify the income you report on the form.

  • Misconception 8: Changes in your living situation don’t need to be reported.
  • Any changes in your household, including new members or moves, must be reported promptly.

  • Misconception 9: You can receive benefits even if you fail to report other income sources.
  • Failure to report all income can lead to overpayments and potential penalties.

  • Misconception 10: The Redetermination form is only for SNAP benefits.
  • This form is also necessary for continuing TANF cash benefits and other assistance programs.

 

State of Illinois

 

 

 

 

 

Department of Human Services

 

 

2(Permanent)

 

 

Redetermination Application

 

 

 

 

 

 

 

Date of Notice:

 

 

Case I.D.:

 

 

Phone:

 

 

Caseload:

 

 

Write your name and address in the space below if not on form.

Your SNAP benefits will end

 

. To keep getting benefits on your regular availability date,

 

 

 

complete, sign and:

 

 

 

return this form in the enclosed envelope by:

 

(Due Date); or

 

 

 

 

 

bring the form with you to your scheduled appointment.

To be considered a valid application, this form must be signed.

If you receive TANF Cash, this form must be completed for your cash benefits to continue.

1. LIST ALL PERSONS LIVING WITH YOU, INCLUDING YOURSELF.

 

 

 

 

 

 

 

 

 

 

EATS WITH YOU

 

FULL NAME

 

BIRTH DATE

 

RELATIONSHIP

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For additional persons, please attach a separate sheet.

 

 

2.

If you receive an HFS Medical Card, has your health insurance changed?

Yes

No

3.

Does anyone get paid for working?

Yes

No If YES, enter their name below. Attach copies of the last 4 pay

stubs if paid weekly, last 2 pay stubs if paid every other week or twice a month, and the last pay stub if paid monthly.

If self-employed, attach your income and expense statement. If someone got tips that are not on their pay stubs, tell us:

Who?

 

and total amount of tips received in the last 30 days. Total Tips $

List the Name of

Everybody Who is

Working

Employer

If a person works more than one job list all the employers.

Rate of Pay

Hours Worked

Weekly

How often is the person paid? Weekly, every 2 weeks, twice a month, monthly, other?

4.

Did anyone start a new job?

Yes

No

5.

Did anyone stop working, or did their job end?

If YES, complete the information above.

Yes

No If YES, enter name, reason, and final pay date.

IL444-4765 (R-05-14) Redetermination Application

Page 1 of 2

Printed by the Authority of the State of Illinois PO #15-0229 12,000 Copies

 

6. During the last 30 days did anyone receive any other income such as Child Support, Social Security, SSI, Unemployment,

VA, Worker's Compensation, contributions, or any other money?

Yes

No

If YES, complete the box below.

Name

Type of Income

Amount

How Often

7. Do you expect any changes in anyone's income or employment?

Yes

No If YES, what is the change?

When do you expect this change to happen?

8. Have you moved or changed your address?

Yes

No If YES, give us your new address.

9. How much is your:

Rent? $

 

Lot Rent? $

 

 

Mortgage? $

 

 

Enter any taxes and homeowner's insurance paid separately $

 

 

Are any of these paid by someone else?

Yes

No

If YES, tell us who and how much:

 

 

 

 

 

10. Did you receive an energy assistance payment of $21 or more this month or in any of the last 12 months from the Low

Income Home Energy Assistance Program (LIHEAP) (in Chicago paid through CEDA)?

Yes

No

 

Answering yes will not reduce your benefits. If no, are you billed separately from your rent or mortgage for heat or air

conditioning, or excess cost for heat or air conditioning?

Yes

No

 

Note: Air conditioning is a window air or central air conditioning unit.

If NO, do you pay any other utilities?

Yes

No

If YES, what utilities?

Does anyone help pay your utilities?

Yes

No If YES, who and what utilities?

11. Does anyone pay child support?

Yes

No If YES, who makes the payments, how much, and how often?

12. Do you pay for someone to care for a child or disabled adult so you can work, look for a job, or receive training?

Yes

No If YES, who is the care for, who provides the care, how much do you pay for the care, and how often?

13.Does anyone who is age 18 or over attend a school, other than a high school, half-time or more? If YES, who?

Yes

No

14. Does someone in your unit who is 60 or older or disabled have monthly medical expenses of $36 or more?

15. Has any person who is receiving Cash assistance from DHS been convicted of a felony involving drugs?

See enclosed page for important information about your application.

Yes

Yes

No

No

SIGNATURE

By signing below, I swear or affirm, under penalty of perjury, the answers on this application are true and correct to the best of my knowledge.

Signature:

 

 

Daytime or Cell Phone Number:

 

Date:

 

 

 

 

 

 

 

IL444-4765 (R-05-14) Redetermination Application

 

 

Page 2 of 2

 

Printed by the Authority of the State of Illinois

PO #15-0229 12,000 Copies

 

 

 

 

 

 

 

Dos and Don'ts

When filling out the Link Illinois Redetermination form, it is essential to approach the process with care and attention. Here is a list of things to do and avoid to ensure your application is complete and accurate.

  • Do read the entire form carefully before starting. Understanding each section will help you provide the necessary information.
  • Do write clearly and legibly. This will prevent any misunderstandings or errors in processing your application.
  • Do include all required personal information, including your name and address, if not already on the form.
  • Do provide details about all individuals living with you. Include their full names, birth dates, and relationships to you.
  • Do attach any necessary documentation, such as pay stubs or income statements, to support your claims about income.
  • Do sign the form before submission. An unsigned application cannot be processed.
  • Do return the form by the due date to avoid interruption in your benefits.
  • Don't leave any questions unanswered. If a question does not apply to you, indicate that clearly.
  • Don't provide false information. Honesty is crucial, as discrepancies can lead to serious consequences.
  • Don't forget to keep a copy of your completed form for your records. This can be helpful for future reference.

By following these guidelines, you can help ensure that your application is processed smoothly and efficiently. Your attention to detail is vital in maintaining your benefits and ensuring that you receive the support you need.

After completing the Link Illinois Redetermination form, submit it by the due date to ensure the continuation of your benefits. You may return the form in the provided envelope or bring it to your scheduled appointment. Remember, your application must be signed to be valid.

  1. Write your name and address in the designated space if it is not already on the form.
  2. List all persons living with you, including yourself, in the provided section. Include their full name, birth date, and relationship to you. Indicate whether each person eats with you.
  3. If you receive an HFS Medical Card, indicate whether your health insurance has changed by selecting yes or no.
  4. State whether anyone in your household gets paid for working. If yes, provide their name and attach the required pay stubs based on their payment frequency.
  5. Indicate if anyone has started a new job or stopped working. If applicable, provide the necessary details.
  6. Report any other income received in the last 30 days, such as Child Support or Social Security. Fill in the name, type of income, amount, and frequency.
  7. Answer whether you expect any changes in income or employment, and describe the anticipated changes.
  8. State if you have moved or changed your address. If yes, provide your new address.
  9. Detail your housing costs, including rent, lot rent, mortgage, and any separate taxes or insurance paid.
  10. Indicate if you received an energy assistance payment of $21 or more in the last 12 months. Also, answer questions about utility payments.
  11. State whether anyone in your household pays child support and provide the necessary details.
  12. Indicate if you pay for someone to care for a child or disabled adult to enable you to work or train. Provide details if applicable.
  13. Answer if anyone age 18 or over in your household attends school at least half-time.
  14. State whether someone aged 60 or older or disabled has monthly medical expenses exceeding $36.
  15. Answer if anyone receiving cash assistance has been convicted of a drug-related felony.
  16. Sign the form and provide your daytime or cell phone number and the date.