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Cash & Food Assistance Forms & Information
Apply for Assistance
To apply for cash or food - apply online through MN Benefits Website or complete the Combined Application Form and call our office for an appointment.
- Application for Food Only For Ages 60 and Up (PDF)
- Disability Information Brochure (PDF)
- Domestic Violence Information Brochure (PDF)
- Electronic Benefits Transfer Brochure (PDF)
- Facts on Voluntarily Quitting Your Job (PDF)
- Family Violence Referral (PDF)
- Important Fraud Notice (PDF)
- Important Info on Other Parent (DOC)
- Information to Apply for Assistance (DOC)
- Program Information for Cash, Food & Child Care (PDF)
- SNAP (Food Benefits) Brochure (PDF)
- Work Registration Notice (PDF)
- Addendum - English (PDF)
- Addendum - Spanish (PDF)
- Asset Assessment for Medical Assistance (PDF)
- Change Report Form - English (PDF)
- Change Report Form - Spanish (PDF)
- Claim Form for Medical Trips (DOC)
- Combined 6 Month Reporting Form (PDF)
- Household Report Form (PDF)
- Release of Information for Assets (PDF)
- Release of Information for Employment (PDF)
- Release of Information for Social Security Administration (PDF)
- Release of Information for General/Other (PDF)
- Shelter Form (PDF)
In accordance with Federal Civil Rights law and U.S. Department of Agriculture (USDA) Civil Rights regulations and policies, the USDA, its agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior credible activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.
USDA is an equal opportunity provider, employer, and lender.