Downloading a Form to Your Computer

  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 application. 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.

    If still having trouble viewing or downloading a form, click here.

Effective Date: 
4/2018

Documents

 

Instructions

Updated: 7/2011

Purpose

  • To provide potential applicants information about SNAP.
  • To provide income assistance workers with a standardized summary to inform recipients of their rights and responsibilities as participants in SNAP.
  • To notify SNAP recipients that they may request a receipt for any reported change(s).
  • To provide the Social Security Administration with a method of informing pure Supplemental Security Income (SSI) households, whose SSI and SNAP applications are jointly processed, of their rights and responsibilities as participants in SNAP.

Procedure

When to Prepare

Give Form H1805 to:

  • potential SNAP applicants to inform them about the program, and
  • all SNAP applicants at initial interviews and at subsequent certification interviews to remind them of their rights and responsibilities as SNAP recipients.

Number of Copies

Give or mail one copy of Form H1805 to the potential applicant, the applicant or the recipient.

Form Retention

There is no retention requirement for this form.

Detailed Instructions

All items on the form are self-explanatory.