Links to County Forms and Documents:

 

GRH Specific Forms for Eligibility

 

• Professional Statement of Need  (PSN) Updated Annually 

• https://edocs.dhs.state.mn.us/lfserver/Public/DHS-7122-ENG

   

• Long Term Homeless Verification  (LTH)

• Supportive Housing (mnhousing.gov 

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•  Habitability Inspection Form 

•   https://edocs.dhs.state.mn.us/lfserver/Public/DHS-7123-ENG 

 

• Shelter Verification Form (SVF) 

• https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2952-ENG

 

• Interim Assistance Agreement Form  (IAA) Updated annually (2 forms; SSI and Non SSI)

   

• SSI version: https://edocs.dhs.state.mn.us/lfserver/Public/DHS-1795-ENG

   

• Non SSI version: https://edocs.dhs.state.mn.us/lfserver/Public/DHS-1795A-ENG

   

Commonly Used Forms

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• Household Report Form         https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2120-ENG

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• Change Report Form                 https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2402-ENG

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• Employment Verification Form     https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2146-ENG

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• CAF (Combined Application Form)     https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5223-ENG

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• Combined Six-Month Report Form      https://edocs.dhs.state.mn.us/lfserver/Public/DHS-5576-ENG

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• Voluntary Vendor Form     https://edocs.dhs.state.mn.us/lfserver/Public/DHS-2984-ENG

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