You are required to answer questions and fill in fields with a red asterisk (*) next to them.
On this page, review your answers for accuracy. If you need to make a change select the pencil and paper icon. If you need to remove something, select the red X icon.
Add a New Person
If you need to add a person to any of the sections on this page, select the person’s name from the Name drop-down and then click the Add button.
If you need a reasonable accommodation or extra help, because of a disability, in order to complete this renewal, enter the type of accommodation or extra help you need.
The term reasonable accommodation means reasonable modifications to the Department’s policies, practices, or procedures that are necessary to allow an individual with a disability to participate meaningfully in the services, benefits, activities, and programs administered by the Department including, but not limited to, alterations in the eligibility and redetermination process that are necessary as a result of the individual’s disability to allow him or her to establish and maintain eligibility notwithstanding his or her disability. A reasonable modification does not include a waiver of any essential factor of eligibility or modification of the Department’s policies, practices, or procedures that would either fundamentally alter the nature of the program or cause undue fiscal or administrative burden on the Department.
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