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<br />~rl\OfS a~cr WJ m\ ~~ S\am\B <br />You can have m re ney <br /> <br />This information is available in other forms to people with disabilities by contacting us at 651-296-0190 <br />(voice) or toll free at 1-800-651-3698. roo users can call the Minnesota Relay at 111 or 1-800-627-3529. <br />For the Speech-to-Speech Relay, call 1-871-627-3848. <br /> <br />If you are 60 years of age or older, answer the following questions to <br />see if you can get help. <br /> <br />Do yon and e"f'tt}"One who I..iveI with you get Supplemental Security Income (55!)? <br /> <br />o <br /> <br />o <br /> <br />Yes <br /> <br />No <br /> <br />Hyoo an.nrcred yes, you. may qwilify for Food Support. To find out how to apply, contact your county <br />human service office or call 651-296-0190 or toll-free 1-800-657-3698. <br /> <br />If you answered no, then answer the questions below. <br /> <br />. Do you live with a spouse or children under 22~ <br /> <br />o <br /> <br />o <br /> <br />No If yes, how many people~ _(a) <br /> <br />Yes <br /> <br />. Are your household assets (cash on hand, money in a checking, savings <br />or an Individmd Retirement Account) less th:m $3,OOO? <br /> <br />o <br /> <br />o <br /> <br />Yes <br /> <br />No <br /> <br />Use the number of people you entered. on line (a), plus yourself. Is your <br />monthly income below the income :unounts listed? Net income is your income <br />after subtracting expenses like shelter, uriliry and medical costs from your gross <br />income (income before taxes). <br /> <br />o <br /> <br />o <br /> <br />No <br /> <br />Yes <br /> <br />Net monthly <br /> <br />Number of people <br />1 <br />2 <br />3 <br />4 <br />5 <br /> <br />Income <br /> <br />$739 <br />$995 <br />$1,252 <br />$1,509 <br />$1,765 <br /> <br /> <br />Note: Income guidt'lines are updated each year. These guidelines are Jar October 1. 2002 - September 30. 2003. <br /> <br />If you answered yes to the fast two questions, yon may be able to get Food Support. <br /> <br />To find out how to apply, contact your county human service office or call 651-296-0190 or call tolffree <br />1-800-657-3698. <br /> <br />DHS-3530-ENG (12-02) <br />