Downloading a Form to Your Computer

Fillable forms cannot be viewed on mobile or tablet devices. Follow the steps below to download and view the form on a desktop PC or Mac.

  1. Right Click for PC or Ctrl + Click for Mac on the PDF link and click “Save link as” from the menu.
  2. Select the folder you want to save the file in and then click "Save."
  3. Navigate to the folder you saved the file in and Right Click for PC or Ctrl + Click for Mac, then select "Open With" from the menu and select Adobe Acrobat Reader DC.

    Note: Open the PDF file from your desktop or Adobe Acrobat Reader DC. Do not click on the downloaded file at the bottom of the browser since it will not open the PDF in Adobe Acrobat Reader DC. It will try to open the file in the browser that results in the same browser error message.

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Effective Date: 



Updated: 6/2002


  • To use as an attachment to GWS and manual
    • Form H1009, TANF/Food Stamp Notice of Eligibility, or
    • Form H1017, Notice of Benefit denial or Reduction
  • To notify a TANF-SP caretaker and/or second parent that
    • TANF-SP benefits are limited to 60 months,
    • what benefit months determine the number of state time limit months used, and
    • when they reach the end of the TANF-SP Time limit, any household member receiving benefits are ineligible for TANF-SP for life.


When to Prepare

Complete Form H1094

  • at application,
  • when adding a new caretaker or second parent, or
  • at complete review if the caretaker/second parent have not previously been informed of the TANF-SP time limit.

Number of Copies

Complete an original and one copy.