Basic Information Summary

This page provides a brief summary of the answers you provided in the Start section.

 

Review the information and confirm it is correct. If you see a mistake in the information you provided, click the Change link to return to the appropriate page and update the information. If you want to erase your changes, click the Erase Changes link.

 

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/LaCAP Re-Enrollment.

 

Click the Previous button to view the previous page.

 

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

 

For Change Reports, Simplified Reports and LaCAP Re-Enrollment Only

 

If you would like to delete information, click the Erase link.

 

For Redeterminations, Change Reports and LaCAP Re-Enrollment Only

 

If you did not previously identify an Authorized Representative and would like to now, click the Add button to add an Authorized Representative.

 

For Redeterminations Only

 

If you need a new EBT card, select Yes or No in the EBT Card section.

 

Enter information in the Contact Information section to tell DCFS how to get in touch with you.