NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 2013

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COMPLETING AN APPLICATION FORM FOR NEW APPLICATIONS AND REAPPLICATIONS FOR
I—AS AND H—-SF

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EIS 2013 - COMPLETING AN APPLICATION FORM FOR NEW APPLICATIONS AND REAPPLICATIONS FOR I—AS AND H—SF


I. GENERAL INFORMATION

II. COMPLETING AN APPLICATION FORM

III. OUTPUTS


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EIS 2013 - COMPLETING AN APPLICATION FORM FOR NEW APPLICATIONS AND REAPPLICATIONS FOR I—AS AND H—SF

REVISED 10/01/07 - CHANGE NO. 02-08

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I. GENERAL INFORMATION

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II. COMPLETING AN APPLICATION FORM

A. Use the following instructions to complete the application. If a numeric field requires less digits than spaces available, precede with zeroes.

REISSUED 10/01/07 - CHANGE NO. 02-08

II. A. (cont’d)

REVISED 10/01/02 - CHANGE NO. 02-03

II. A. (cont’d)

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III. OUTPUTS

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