Appendix A: Applications/Renewal Chart, Forms to Distribute/Complete

NOTE:  Other specialized forms may be necessary.

Type of Household

Application

Renewal

These Forms May Also Be Required as Applicable Miscellaneous

TANF

PA 253 or PA 253RF
PA 600
PA 4
PW 764
PA 1661

PA 253 or PA 253RF
PA 600R
PA 4
PW 764
PA 1595
PA 1661

PA 635 or PA 586
PA/CS173WP
PA 1680
PA 1747

Length of period - 6 months - not subject to semiannual reporting.

Length of period - 12 months - subject to semiannual reporting.

 

***See Chapter 104, Appendix A. for client information brochures

 

Reissued September 25, 2012, replacing  January 31, 2012