Haw. Code R. § 5-31-15 - Application information

The following information may be required to complete the application:

(1) The applicant's social security number and date of birth;

(2) The applicant's last four pay stubs;

(3) The applicant's most recent federal or state income tax return;

(4) Child care receipts for the last three months;

(5) Birth certificates for each child in the family;

(6) Social security numbers and dates of birth for each child and non-applicant party;

(7) Address information for all parties;

(8) Information when the child has received temporary-assistance for needy families or medicaid any time in the State or in other states;

(9) Information on the applicant's employer and work history;

(10) Information on the employer and work history of the other parent of the child(ren);

(11) Information on or availability and cost of medical coverage for the child(ren) by either parent;

(12) All child support orders;

(13) Information on ownership of real property by the noncustodial parent;

(14) Information on financial accounts held by either parent;

(15) Work, home, and cellular telephone numbers for both parents;

(16) Information on both paternal and maternal grandparents for each child;

(17) Caretaker information if the children are not living with the mother or the father;

(18) Marriage or divorce or separation history of both parties, marriage certificate, and divorce decree; and

(19) Restraining orders issued by the court.

Notes

Haw. Code R. § 5-31-15

[Eff and comp MAR 30 2014] (Auth: HRS §§ 576D-2, 576D-6) (Imp: HRS §§ 576D-2, 576D-6; 45 C.F.R. §303.2)