Public Assistance
Forms and Information
- Use the following forms for Public Assistance programs only.
- Refer to our offices for other forms not listed here.
- These forms are updated regularly. Please use the links below for the most current form
One Fax for All OfficesDPA’s statewide toll-free fax number is 888-269-6520, and Anchorage area residents can dial 907-269-6520.
Supplemental Nutrition Assistance Program (SNAP)
(Formerly Food Stamps)
Medicaid Trusts
Qualifying Income Trusts (MED 23)
Provides information about establishing a Qualifying Income Trust (aka Miller’s Trust) when an individual has too much countable income to qualify for Medicaid benefits
Special Needs and Pooled Trusts (MED 22)
Provides information about establishing a Special Needs or Pooled Trust when a disabled individual has too much countable income or too many countable resources to qualifying for Medicaid benefits