To complete this form please be sure you have the following:
• proof of income for all income sources
• the proof of income must be available to upload (scans or photos of documents)
• all household members 16+ must digitally sign this form
Note: You cannot return to this form. If you do not finish, you will need to start over.
This form should take 15-30 minutes to complete.
Electronic Signature Agreement. Throughout this process, you will be asked to provide electronic signatures at various points. By submitting this form, you certify that the information provided is true and accurate and all adult members of the household are present for their signatures. You also agree that your electronic signature is the legal equivalent of your manual signature on these forms.
We have moved to a shared caseload based on last name.
If your last name is between A-L you will be assigned to the gold team.
Last names M-Z you will be assigned to the blue team.
Both teams can be accessed through our customer care team.
Our customer care team is available to answer any questions and direct you to the right team.
Customer Care can be reached at 253.207.4400 or email@example.com