To confirm your eligibility when applying for one of our benefit programs, you'll need to submit proof of facts (information about you and others on your case). Advisors complete this form for clients certified for TANF (and prior Medicaid, if appropriate) and SNAP.Form to apply for Food Benefits (SNAP), Healthcare (Medicaid and CHIP), or cash help for families (TANF) (H1010). These pictures tell you what sections you need to fill out. On the chart below, fill in the first line with information about yourself. Fill in the remaining lines for everyone who lives in the house with you,. Call 2-1-1 or 1-877-541-7905. Complete our Financial Intake Form and provide documentation for proof of eligibility (see Common Documents list below).