Information Needed for SNAP Benefits

The SNAP worker may need to see certain information. This will help the SNAP worker complete your application and make a decision about your SNAP benefits. 

Not all items are required. The SNAP worker will discuss your situation with you and mark items you need by checking the blocks on this form. 

Identity
   ___ Driver’s License
   ___ Work or school identification card
   ___ Health benefits identification card
   ___ Voter registration card
   ___ Birth certificate

Residency
   ___ Voter registration card
   ___ Library card that shows address
   ___ Utility bills
   ___ Rent or mortgage receipts that show address
   ___ Piece of mail received at stated address

Earned Income
   ___ Pay stubs
   ___ Statement from employer
   ___ Employee W-2 form
    ___ Income tax forms
   ___ Self-employment bookkeeping records

Unearned Income:
    ___ Bank statements
   ___ Benefit award letter or benefit payment check
   ___ Divorce or separation decrees
   ___ Child support agreement
   ___ Income tax forms
   ___ Self-employment bookkeeping records
   ___ Rental agreement or lease
   ___ Unemployment compensation award letter

Immigration Status
Immigration and Naturalization Papers (Not required if you are not eligible to receive SNAP benefits but are applying for your children who were born in the United States.) 

Information You May Need To Complete the SNAP Application

Shelter/Housing Costs
(A document for each cost may be requested.)
   ___ Utility bills (electric, gas, water, trash and sewage, and
         telephone)
   ___ Rent receipts
   ___ Statement from landlord
   ___ Mortgage receipts
   ___ Insurance policy for home or rental
   ___ Real estate agreement
   ___ Other

Resources
   ___ Bank statements or books
   ___ Stocks and bonds certificates
   ___ Deeds
   ___ Sales agreement
   ___ Life estate agreement
   ___ Funeral agreement
   ___ Real estate tax receipt
   ___ Income tax return
   ___ Life insurance policy
   ___ Other

Dependent Care Deduction
   ___ Paid receipt
   ___ Canceled checks
   ___ Tax records
   ___ Statement from child care provider
   ___ Other

Medical Expense Deduction 
(for households with elderly and disabled persons only)
   ___ Billing Statements
   ___ Itemized receipts
   ___ Medicare card indicating Part “B” coverage
   ___ Medicine bottles with costs on label
   ___ Repayment agreement with physician
   ___ Bills or receipt for prescribed equipment or medical supplies
         (includes rental costs)
   ___ Transportation and lodging receipts for obtaining medical 
         treatment
   ___ Other 

Information You May Need To Complete the SNAP Application

Age
(documents may be requested to show the age of certain members in your family, such as elderly persons)
   ___ Birth certificate
   ___ Adoption papers or records
   ___ Hospital or clinic records
   ___ Records from religious organization
   ___ U.S. Passport
   ___ Other

Child Support Expense 
(Two documents may be requested. One showing legal obligation and one showing payments made)
   ___ Court order or other legal document
   ___ Canceled checks
   ___ Income statement if income for child support is withheld
   ___ Statement from person to whom payments are made
   ___ Other 

Last modified: 04/11/2012