Michigan Verification Student Form PDF Details

Are you a student living in Michigan who needs to verify their identity? Are you feeling overwhelmed by the paperwork required to do so? If so, this guide on the Michigan Verification Student Form should help point you in the right direction. In this blog post, we provide detailed instructions and explanations of the verification process as well as any important information regarding valid forms of identification that are accepted. This way, we can make sure that verifying your student status is easy and stress-free!

QuestionAnswer
Form NameMichigan Verification Student Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesverification student information get, michigan verification form online, dhs 3380 verification, michigan student form

Form Preview Example

ENTER ADDRESSEE NAME ENTER ADDRESSEE CARE OF

ENTER ADDRESSEE PO BOX OR STREET ENTER ADDRESSEE CITY/STATE/ZIP

Case Name:

 

Case Number:

 

Date:

 

DHS Office:

 

Specialist / ID:

/

Phone:

 

Fax:

 

Individual ID:

 

Department of Human Services (DHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or expression, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you are invited to make your needs known to a DHS office in your area. AUTHORITY: Act 280 of 1939, as amended, and Title IV and XIX of the Social Security Act.

COMPLETION: The school administration's voluntary cooperation is requested.

PENALTY: None for the school administration’s refusal to fill out form. However, failure of school to provide information may result in denial, reduction, or loss of assistance for client.

VERIFICATION OF STUDENT INFORMATION

Student Name

Student’s Birthdate

Date Completed

CLIENT INSTRUCTIONS & RELEASE OF INFORMATION:

•It is necessary to verify school enrollment, attendance and progress for students who are receiving or applying for public assistance. For the Family Independence Program, all children between the ages of 6-18 are expected to be attending school full-time or benefits may be denied, reduced, or terminated.

•This form must be completed by the school. Sign below, then take or mail the form and the return envelope to the school.

• It is your responsibility to have the form completed and returned to your worker by

or your

benefits may be denied, reduced, or terminated.

 

To school official: You are authorized to release the information requested below to the Department of Human Services.

Client Signature

Date

INSTRUCTIONS FOR SCHOOL OFFICIAL:

We are requesting your help in verifying enrollment, attendance and progress of the above-referenced student. Please complete the information on the back of this form and return it to our office. A stamped self-addressed envelope has been enclosed for that purpose.

TO BE COMPLETED BY SCHOOL OFFICIAL:

 

1.

Name of School

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of School

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

 

2.

Name of Responsible Person With Whom the Student is Residing

 

 

3. Relationship to Student

 

 

 

 

 

 

 

 

 

 

4.

Address of Student's Home

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

 

5.

Enrollment Status:

 

 

 

 

 

 

 

 

FULL TIME STUDENT

 

HALF TIME STUDENT

LESS THAN HALF TIME

NOT CURRENTLY ENROLLED

 

6.

Attendance:

 

 

 

 

 

Since (Give Date)

 

 

REGULARLY ATTENDING

 

ATTENDING SOMETIMES

NOT ATTENDING

 

 

 

If not regularly attending, is absence due to disability or periods of extended illness?

Yes

No

 

DHS-3380 (Rev. 10-12) Previous edition obsolete. MS Word

1

 

 

 

Case Name

Case Number

Specialist

7.

Type of Program

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VOCATIONAL TRADE OR TECHNICAL TRAINING

 

K-12

 

COLLEGE OR UNIVERSITY

 

YES

NO

Is a High School diploma/GED Required for this program

8.

Curriculum or Major

Participating in Work Study

 

School Year/Term/Semester Begin Date

End Date

 

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

9.

Degree Being Pursued:

 

ASSOCIATE OF ARTS DEGREE

NOT APPLICABLE

 

Expected Date of Completion/Graduation

 

HIGH SCHOOL DIPLOMA

 

B.A./B.S

 

OTHER (Specify)

 

 

21 Day Compliance Test

Complete if box is checked

10. Has the child regularly attended all school days for the past 21 calendar days?

Yes

No

11. Comments

12. Signature of School Official

Title

Phone Number

Date

DHS-3380 (Rev. 10-12) Previous edition obsolete. MS Word

2

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This document requires particular data to be entered, thus you should definitely take whatever time to provide exactly what is requested:

1. Start completing your michigan student information online with a group of necessary blanks. Gather all the required information and make sure not a single thing left out!

michigan verification form online completion process shown (part 1)

2. Soon after this part is filled out, go on to type in the applicable details in all these: Student Name, Students Birthdate, Date Completed, CLIENT INSTRUCTIONS RELEASE OF, It is necessary to verify school, This form must be completed by, school It is your responsibility, or your, To school official You are, Date, INSTRUCTIONS FOR SCHOOL OFFICIAL, TO BE COMPLETED BY SCHOOL OFFICIAL, Name of School, Address of School, and Name of Responsible Person With.

or your, To school official You are, and Student Name inside michigan verification form online

3. In this stage, examine Name of Responsible Person With, Address of Students Home, Enrollment Status, FULL TIME STUDENT, Attendance, Relationship to Student, City, HALF TIME STUDENT, LESS THAN HALF TIME, NOT CURRENTLY ENROLLED Since Give, REGULARLY ATTENDING, If not regularly attending is, ATTENDING SOMETIMES, NOT ATTENDING, and Yes. These need to be filled out with highest accuracy.

The right way to fill in michigan verification form online part 3

People who work with this form often make some mistakes when filling in If not regularly attending is in this section. Make sure you review whatever you type in right here.

4. To go ahead, this next form section will require filling in a handful of empty form fields. Examples include Case Name, Type of Program, Curriculum or Major, Degree Being Pursued, HIGH SCHOOL DIPLOMA, Day Compliance Test, Complete if box is checked, Case Number, Specialist, COLLEGE OR UNIVERSITY, VOCATIONAL TRADE OR TECHNICAL, Is a High School diplomaGED, Participating in Work Study, School YearTermSemester Begin Date, and YES ASSOCIATE OF ARTS DEGREE BABS, which are key to continuing with this particular PDF.

Is a High School diplomaGED, COLLEGE OR UNIVERSITY, and Curriculum or Major of michigan verification form online

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