JFS Applications and Forms
PUBLIC ASSISTANCE PROGRAMS - Food Assistance, Child Care, Medicaid, Cash and Prevention Retention & Contingency (PRC) Program.
Online Application now available! To apply online for Cash Assistance (OWF), Food Assistance or Medical Benefits or to report changes, click here.
Public Assistance forms that can be printed and submitted:
- Self Serve Application
- Application for all Public Assistance Benefits (SNAP/TANF/Medicaid/Child Care)(JFS-07200)
- Application for Child Support (JFS-07076)
- Comprehensive Case Management and Employment Program (CCMEP) Application
- Change Report Form
- Designation of Authorized Representative
- Employment Verification Form
- Interim Report (JFS-7221)
- PRC Application
- PRC Plan
- Statement Requesting Replacement of Supplemental Nutrition Assistance Program (SNAP) Benefits Form (JFS-07222)
- Supplemental Tax Questions Form
- Verification of Termination of Employment
- Verification of New Employment
- Landlord Certification
TO FAX: 330-297-3439
TO MAIL: PCDJFS, 449 South Meridian Street - 2nd floor, Ravenna, Ohio 44266
TO DROP OFF: Portage County Administration Building, 449 South Meridian Street - 2nd floor, Ravenna
For additional Public Assistance information, send an email.