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How do I fill this out?
To fill out this form, carefully read each section and provide the requested information accurately. Use a pen and make sure not to leave any required fields blank. If you are uncertain about any answer, ask a county welfare worker for assistance.

How to fill out the Application and Affidavit for Public Assistance?
1
Read through the entire form before beginning.
2
Fill out personal information such as name, address, and household details.
3
Provide information about the programs you are applying for.
4
Indicate whether you are willing to work and if applicable, authorize someone to assist.
5
Review your completed application for accuracy and sign it.
Who needs the Application and Affidavit for Public Assistance?
1
Individuals seeking Temporary Assistance for Needy Families (TANF) for support.
2
Families requiring assistance through the New Jersey Supplemental Nutrition Assistance Program (SNAP).
3
Those needing help covering general assistance or emergency needs.
4
Residents in institutional settings looking to apply for benefits upon release.
5
Guardians applying for kinship care subsidies for children in their care.
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1
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What are the instructions for submitting this form?
Submit this application by mailing it to the local county welfare office. You may also fax the completed form to the designated fax number listed on the form. For convenience, check if an online submission option is available through the state’s assistance programs website.
What are the important dates for this form in 2024 and 2025?
Please check the latest deadlines for submitting applications to ensure timely assistance. Essential programs like TANF and SNAP typically have specific periods for application processing. Verify dates for 2024 to avoid missing any opportunities.

What is the purpose of this form?
The purpose of this form is to facilitate access to public assistance programs available in New Jersey. It allows applicants to apply for vital support such as food assistance and financial assistance. Completing this form is the first step in securing necessary resources during times of need.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant's name: The full name of the applicant, including last, first, and middle names.
- 2. Resident Address: The physical address where the applicant currently resides.
- 3. Phone Number: Contact numbers for the applicant, including home, work, and cell.
- 4. Program Selection: Options for various assistance programs the applicant is applying for.
- 5. Income Information: Details regarding household income and resources.
- 6. Authorized Representative: Information for any person authorized to assist with the application.
What happens if I fail to submit this form?
Failure to submit this form will result in not being able to access vital assistance programs. As a result, the applicant may experience ongoing financial hardships without the support they need. It's crucial to complete and submit the form promptly to avoid delays.
- Loss of Benefits: Applicants may miss out on critical financial aid and nutritional support.
- Increased Financial Hardship: Not applying can lead to unresolved financial struggles and instability.
- Missed Deadlines: Timing is essential; missing the application deadline can delay access to benefits.
How do I know when to use this form?

- 1. Applying for TANF: Use this form to apply for Temporary Assistance for Needy Families.
- 2. Applying for SNAP: This form is necessary to apply for Supplemental Nutrition Assistance Programs.
- 3. General Assistance: Utilize this form for general assistance applications based on eligibility.
Frequently Asked Questions
What is this application for?
This application is for individuals seeking public assistance programs in New Jersey.
How do I access the PDF editor?
You can open this PDF in the PrintFriendly editor directly from our website.
Can I save my changes?
Yes, you can download the edited document after making changes.
Is there an option for someone else to apply on my behalf?
Yes, you can authorize someone to apply for benefits on your behalf.
What information do I need to fill out?
You'll need personal and household information, including names, addresses, and financial details.
How long does the application process take?
Processing times can vary, but assistance benefits are generally determined quickly.
What if I'm unsure about a question?
If you are unsure about any questions on the form, seek help from a county welfare worker.
How do I submit the application?
After completing, you can submit it according to the instructions provided on the form.
Is there a fee to apply?
No, applying for these assistance programs is free of charge.
Can I track my application status?
Yes, you can follow up with the county welfare agency to check your application status.
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