Left Household Details

This page displayed because you indicated someone left your household. If this is in error, click the Previous button and correct the information.

 

Some items have an asterisk (*) next to them, indicating they are mandatory. You must fill in these items before you can continue to the next page.

 

Enter the date that this individual left the household.

 

Select the most applicable reason from the Reason this person left the household drop-down menu. You will have the opportunity to provide further explanation during an interview with a DCFS worker.

 

Click the Print button to print this page for your reference.

 

Click the Next button to save and continue with the online Redetermination/Change Report/Simplified Report.

 

Click the Previous button to view the previous page.

 

Click the Save & Exit button to exit the online Redetermination/Change Report/Simplified Report and save your progress on your Redetermination/Change Report/Simplified Report. The Redetermination/Change Report/Simplified Report is saved as Incomplete.