Michigan Form DHS-1171, the Assistance Application, is the single intake form the Michigan Department of Health and Human Services uses to screen households for the Food Assistance Program (FAP/SNAP), Medicaid (MA), the Family Independence Program (FIP) cash assistance, the Child Development and Care (CDC) subsidy, and State Emergency Relief (SER). Any Michigan resident who needs food, medical, cash, child care, or emergency help files this one form to start every program at once.
The current paper version is the DHS-1171 (Rev. 8-22), and you should confirm the revision date in the bottom-left corner before you write on it. Filing the wrong version, leaving income blank, or skipping the signature on the rights and responsibilities page is the fastest way to get a denial notice in the mail. In federal fiscal year 2024, MDHHS processed more than 1.3 million SNAP cases, and roughly one in five paper applications gets sent back for missing information on the first pass.
Here is what you will learn in this guide:
- 📝 How to complete every page of DHS-1171 line by line, in plain English
- 🍞 How to qualify for expedited food assistance within 7 days
- 👨👩👧 Three full filled-out examples using real-life Michigan households
- 📬 Every way to file the form (online, mail, fax, in person) with addresses and links
- ⚠️ The 10 most common mistakes that cause denials and how to avoid them
What the Form Is and Who Must File It
DHS-1171 is the master Assistance Application for Michigan public benefits. The form is authorized by the Michigan Social Welfare Act at MCL 400.10, and it carries out federal rules in 7 CFR Part 273 for SNAP and 42 CFR Part 435 for Medicaid.
You must file DHS-1171 if you live in Michigan and you want to apply for any of these programs: FAP (food stamps), Medicaid for adults or children, FIP cash assistance, the CDC child care subsidy, or SER for utility shutoffs, evictions, burials, or home repairs. You can also file on behalf of someone else as an authorized representative if the applicant is sick, elderly, or unable to act for themselves.
The same form serves single people, families, seniors, disabled adults, mixed-status immigrant households, college students, and people who are temporarily homeless. You only fill in the sections that apply to your situation, and you skip the rest. The agency caseworker uses your answers to test you against every program at once, which is why the form is long but only needs to be filed once.
The receiving agency is your local MDHHS county office, and the program rules live in the Bridges Eligibility Manual (BEM). If you skip this form and try to apply by phone or by walking in without paperwork, the worker will still hand you DHS-1171 to sign because federal law requires a written, signed application before benefits can begin.
Before You Start: Documents and Information You Need
Gather everything below before you open the form. Missing items are the number-one reason DHS-1171 gets returned, and federal SNAP rules under 7 CFR 273.2(c) let the agency delay or deny you if verification does not arrive within 10 days of the request.
- Photo ID for the head of household. A Michigan driver’s license, state ID, passport, or tribal ID works. Without ID, the worker cannot confirm you are who you say you are, and the file sits in pending status.
- Social Security numbers for every household member applying. SSNs are required for FAP and FIP under 7 CFR 273.6. A child without an SSN can still get Medicaid, but not FAP.
- Proof of Michigan residency. A lease, utility bill, or piece of mail addressed to you at a Michigan address. Homeless applicants can write homeless in the address box and still qualify.
- Proof of all income for the last 30 days. Pay stubs, self-employment records, unemployment award letters, Social Security award letters, child support print-outs, and pension statements all count.
- Proof of housing costs. Your lease or mortgage statement, plus a current heating bill if you pay separately for heat. Heat costs unlock the Heat and Utility Standard deduction that boosts your FAP allotment.
- Proof of dependent care costs. Day care receipts, after-school program bills, or paid invoices for adult day care for a disabled household member.
- Proof of medical expenses (seniors and disabled adults only). Pharmacy print-outs, Medicare premium notices, and doctor bills over $35 per month qualify for the medical expense deduction on FAP.
- Immigration documents for non-citizen members. Permanent resident cards, employment authorization documents, or refugee/asylee paperwork. Mixed-status households are allowed; only the non-eligible adult is left off the benefit count.
- Bank statements for the last month. Required for FIP and SER. FAP no longer counts most assets, but Medicaid for seniors and disabled adults still has an asset test.
- Pregnancy verification, if applicable. A note from your doctor or clinic. Pregnancy adds one to your household size for FAP and unlocks Healthy Michigan/Medicaid for pregnant women.
If you cannot find a document, do not delay. File the form anyway with what you have, because the date of application is the date MDHHS receives a signed form with at least your name, address, and signature. Verification can follow inside the 10-day window.
Where to Get the Form and How to Access It
The official PDF lives on the MDHHS website as DHS-1171 Assistance Application. You can print it at home, pick up a paper copy at any MDHHS local office, or ask a community partner like a food bank, hospital social worker, or Area Agency on Aging to print one for you.
The fastest way to file is online through MI Bridges, Michigan’s secure benefits portal. MI Bridges walks you through the same questions DHS-1171 asks, but it skips fields that do not apply to your household, so the average online application takes about 45 minutes versus 90 minutes on paper.
If you prefer paper, the DHS-1171-FF (Filled-In Sample) and the companion DHS-1171-INS (Instructions) are available alongside the main form. The form is also offered in Spanish as DHS-1171-SP and in Arabic. Large-print and accessible versions are available on request under Title VI of the Civil Rights Act and the ADA.
If you are blind, deaf, or have a disability that prevents you from filling out the form, MDHHS must offer reasonable accommodation, including reading the form to you over the phone or sending a worker to your home. Call Michigan 2-1-1 to find local help.
Step-by-Step: How to Fill Out DHS-1171 Line by Line
The paper form is roughly 22 pages, broken into numbered sections. Use blue or black ink, write in capital letters, and never use white-out — cross a mistake out with a single line, write the correct entry next to it, and initial the change.
Page 1, Box 1: Programs You Are Applying For
This is the first set of checkboxes on the cover page, asking which programs you want.
What the field asks in plain English. It asks which kinds of help you want — food, medical, cash, child care, or emergency.
How to answer it. Check every box that applies. There is no penalty for checking too many; the worker will only approve programs you qualify for.
A specific example answer. Maria Lopez checks Food Assistance, Healthcare Coverage, and Child Development and Care because she needs food help, Medicaid for her kids, and day care help for her toddler.
A nuance or edge case. If you only want medical coverage, check Healthcare Coverage alone — but most filers should also check Food Assistance because the income limit for FAP is higher than people expect (200% of poverty in Michigan).
A common mistake on this field and its direct consequence. Filers often skip this box thinking it is optional. If you leave every box blank, MDHHS may default-screen you for FAP only and miss your Medicaid application, costing you months of coverage.
A misconception people hold about this field. Many believe checking Cash Assistance hurts your chance of getting Medicaid. It does not — programs are evaluated separately under BEM 105.
Page 1, Box 2: Head of Household Name
What the field asks in plain English. It asks for the full legal name of the person filing the application.
How to answer it. Write your first name, middle initial, and last name exactly as they appear on your Social Security card. Use all capital letters.
A specific example answer. MARIA E LOPEZ writes her name in the box.
A nuance or edge case. If you recently married or divorced and your Social Security card has not been updated, use the name on the card, not the new name. A name mismatch with SSA triggers a verification hold.
A common mistake on this field and its direct consequence. Writing a nickname like Liz instead of Elizabeth causes the SSA cross-match to fail, which delays benefits by 10–30 days.
A misconception people hold about this field. People think the head of household must be the highest earner. It does not — it is whoever is filing and takes responsibility for the application.
Page 1, Box 3: Mailing Address
What the field asks in plain English. It asks where MDHHS should mail your notices and your Bridge Card.
How to answer it. Write your street address, apartment number, city, state, and ZIP. If you use a P.O. Box, write it on the mailing address line and put your physical address on the home address line below.
A specific example answer. MARIA LOPEZ writes 2415 W GRAND BLVD APT 3B, DETROIT MI 48208.
A nuance or edge case. If you are homeless, write HOMELESS and list a shelter address, a friend’s address, or the local MDHHS office as your mailing address. Homelessness is not a bar to benefits under BEM 400.
A common mistake on this field and its direct consequence. Writing only a P.O. Box with no physical address triggers a residency verification request, which adds at least 10 days to processing.
A misconception people hold about this field. Filers think they must own or lease the home. You can be a guest, a couch-surfer, or a temporary stay and still qualify.
Page 1, Box 4: Phone, Email, and Preferred Contact
What the field asks in plain English. It asks how MDHHS should reach you for interviews and missing-document requests.
How to answer it. Write a working phone number and a checked email address. Pick one as your preferred contact.
A specific example answer. MARIA LOPEZ lists (313) 555-0142 and maria.lopez@gmail.com and checks Text Message as her preferred method.
A nuance or edge case. If you do not have a phone, list a trusted relative or a shelter caseworker, and write messages OK next to the number.
A common mistake on this field and its direct consequence. Listing a disconnected number means MDHHS cannot do your required interview, and your case will be denied for failure to comply under BEM 115.
A misconception people hold about this field. Filers think MDHHS will only call once. They will, but if the call is missed, the denial follows quickly — call the office back the same day.
Page 2, Section A: Household Members
What the field asks in plain English. It asks who lives with you and buys/eats food with you.
How to answer it. List every person, starting with yourself. Include name, date of birth, SSN, relationship, sex, and whether each person is applying. Use MM/DD/YYYY for dates.
A specific example answer. Maria lists herself, her son Diego Lopez (06/14/2019), and her mother Elena Vasquez (03/02/1958) who lives with them.
A nuance or edge case. A roommate who buys and cooks food separately is not in your FAP household, even if you share a kitchen. Write them on the form but mark does not purchase/prepare food with applicant.
A common mistake on this field and its direct consequence. Leaving a child off the form because the other parent claims them on taxes is wrong — FAP household rules are not tax rules, and missing a child shrinks your benefit.
A misconception people hold about this field. People think a spouse who is separated but still in the home can be left off. They cannot — spouses living together must be on the same case under BEM 212.
Page 3, Section B: Citizenship and Immigration
What the field asks in plain English. It asks the immigration status of each applying member.
How to answer it. Check U.S. Citizen or list the immigration category and write the alien registration number (A-Number) for any non-citizen applying.
A specific example answer. Maria checks U.S. Citizen for herself and Diego, and writes Lawful Permanent Resident, A123-456-789 for Elena.
A nuance or edge case. Non-applying household members do not have to provide immigration status. Write NOT APPLYING in the status box for them. Federal law forbids the agency from asking further.
A common mistake on this field and its direct consequence. Listing a non-applying parent’s status anyway scares mixed-status families and can chill the entire application — leave it blank.
A misconception people hold about this field. People believe applying for FAP for a citizen child counts as a public charge. It does not under current USCIS public charge guidance.
Page 4, Section C: Expedited Food Assistance Screening
What the field asks in plain English. It asks if you have very little money and need food within 7 days.
How to answer it. Answer Yes or No to three questions: gross income under $150 with under $100 in cash, rent/utilities greater than income plus cash, or migrant/seasonal worker status.
A specific example answer. Marcus Johnson, a recently unemployed warehouse worker with $60 in his account and $0 income, checks Yes and qualifies for expedited FAP.
A nuance or edge case. Even if you fail the expedited test, you still get regular FAP within 30 days. Expedited only changes the speed.
A common mistake on this field and its direct consequence. Skipping this section because it looks optional. If you qualify but do not check the boxes, you wait 30 days instead of 7.
A misconception people hold about this field. Filers think expedited means a smaller benefit. It does not — the dollar amount is the same; only the timing is faster, per 7 CFR 273.2(i).
Page 5, Section D: Earned Income
What the field asks in plain English. It asks how much each working person earns from a job or self-employment.
How to answer it. List employer name, address, gross pay (before taxes), pay frequency, and start date. Attach the last 30 days of pay stubs.
A specific example answer. Maria Lopez lists Henry Ford Health, 2799 W Grand Blvd, Detroit MI, gross $1,840 monthly, paid bi-weekly, started 03/01/2023.
A nuance or edge case. Self-employed filers list gross receipts minus business expenses. Keep a simple ledger; MDHHS will accept a hand-written one under BEM 502.
A common mistake on this field and its direct consequence. Reporting take-home (net) pay instead of gross. The worker will use your stub anyway and may flag the mismatch, slowing processing.
A misconception people hold about this field. Filers think tips do not count. Tips are earned income and must be reported.
Page 6, Section E: Unearned Income
What the field asks in plain English. It asks about money that comes in without working — Social Security, unemployment, child support, pensions, VA benefits.
How to answer it. List the source, monthly amount, and the date the payment arrives.
A specific example answer. Elena Vasquez lists Social Security Retirement, $1,210/month, 3rd of the month.
A nuance or edge case. Child support paid to you counts as income. Child support you pay out is a deduction — list it in Section H.
A common mistake on this field and its direct consequence. Forgetting to list a small Social Security payment because it feels too small. Unreported income is the top reason for Intentional Program Violation (IPV) findings under BAM 700.
A misconception people hold about this field. People believe tax refunds count as income. They do not — the IRS §6409 excludes refunds for 12 months.
Page 7, Section F: Assets
What the field asks in plain English. It asks what you own — bank accounts, cars, life insurance, property.
How to answer it. List each account, balance, vehicle (year/make/model/value), and any property other than your home.
A specific example answer. Janet Williams, applying for senior Medicaid, lists Chase checking $1,420, 2014 Toyota Corolla $7,500, term life insurance no cash value.
A nuance or edge case. FAP no longer has an asset test for most households. Medicaid for seniors and disabled adults still uses a $2,000 individual / $3,000 couple limit under BEM 400.
A common mistake on this field and its direct consequence. Listing your home or your one car. Your primary home and one vehicle are exempt — listing them does not hurt you, but failing to list a second vehicle is fraud.
A misconception people hold about this field. Filers think a 401(k) counts. Retirement accounts are exempt for FAP and most Medicaid categories.
Page 8, Section G: Housing and Utility Costs
What the field asks in plain English. It asks what you pay for rent or mortgage and utilities.
How to answer it. Write monthly rent or mortgage, property tax, homeowner’s insurance, and check every utility you pay (heat, electric, water, phone, trash).
A specific example answer. Maria Lopez writes $950 rent, heat included, $85 electric, $40 phone.
A nuance or edge case. Even if heat is included in rent, check the Heat and Utility Standard box if you pay any separate utility — it gives you the maximum standard utility allowance and bumps your FAP.
A common mistake on this field and its direct consequence. Forgetting to check the heat box. Missing this single check can cost a family $100+ per month in FAP benefits.
A misconception people hold about this field. People think only homeowners get the shelter deduction. Renters get it too, and it is one of the biggest benefit-boosters on the form.
Page 9, Section H: Expenses and Deductions
What the field asks in plain English. It asks about child care, medical bills, child support paid out, and other deductible expenses.
How to answer it. List each expense type, monthly amount, and who you pay.
A specific example answer. Maria lists day care $480/month to Bright Start Learning Center and court-ordered child support paid out $200/month.
A nuance or edge case. Medical expense deductions are only for household members age 60+ or disabled, and only the amount over $35 per month counts.
A common mistake on this field and its direct consequence. Skipping medical bills because Medicare covers most of them. The Medicare Part B premium ($174.70+ in 2024) alone qualifies and increases your FAP.
A misconception people hold about this field. Filers think they need receipts for every expense. A reasonable estimate is enough at application; receipts come at review.
Page 10, Section I: Pregnancy and Disability
What the field asks in plain English. It asks if anyone is pregnant or disabled.
How to answer it. Check yes/no for each member; if yes, list due date or disability type.
A specific example answer. Aisha Brown checks pregnant, due 11/15/2026.
A nuance or edge case. Pregnancy adds one to FAP household size starting the month it is reported, not the month of birth.
A common mistake on this field and its direct consequence. Not reporting pregnancy because you have not told family yet. The form is confidential under HIPAA and reporting unlocks pregnancy Medicaid and a bigger FAP benefit.
A misconception people hold about this field. People think disability requires an SSDI letter. A doctor’s note works for FAP and CDC purposes.
Page 12, Section J: State Emergency Relief (SER)
What the field asks in plain English. It asks if you have a current crisis — eviction, shutoff, no heat, fire, or burial cost.
How to answer it. Check the crisis type, write the dollar amount needed, and attach the shutoff or eviction notice.
A specific example answer. Marcus Johnson checks Energy — Electric Shutoff, writes $385 past-due, and attaches the DTE shutoff notice dated 05/10/2026.
A nuance or edge case. SER has an annual cap (currently $850 for energy) and requires you to pay a co-pay based on income. Always apply early — SER cannot pay after service is restored.
A common mistake on this field and its direct consequence. Waiting until shutoff day. SER decisions take up to 10 days, so you may lose service while the case is pending.
A misconception people hold about this field. People think SER is a loan. It is a grant and does not need to be paid back.
Page 14, Rights and Responsibilities Signature Page
What the field asks in plain English. It asks you to swear that everything is true and to sign and date the form.
How to answer it. Read the rights, sign your full legal name in cursive, print it, and write today’s date.
A specific example answer. Maria Lopez signs Maria E. Lopez, prints MARIA E LOPEZ, dates 05/21/2026.
A nuance or edge case. An authorized representative may sign for you with a written designation form (DHS-4583).
A common mistake on this field and its direct consequence. Forgetting to date the signature. An undated signature makes the application invalid and resets your filing date, which can cost you a month of benefits.
A misconception people hold about this field. Filers think a signature on page 1 alone is enough. The rights page on page 14 must be signed too — the cover page is not a substitute.
Three Filled-Out Examples Using Real Scenarios
These three named filers show how DHS-1171 looks for the most common Michigan households.
Example 1: Maria Lopez — Single Mother Applying for FAP, Medicaid, and CDC
| Form Section | What Maria Enters |
|---|---|
| Programs requested (Box 1) | Food Assistance, Healthcare Coverage, Child Development and Care |
| Head of household (Box 2) | MARIA E LOPEZ |
| Address (Box 3) | 2415 W GRAND BLVD APT 3B, DETROIT MI 48208 |
| Household members (Section A) | Maria Lopez (self), Diego Lopez (son, age 6) |
| Citizenship (Section B) | U.S. Citizen for both |
| Earned income (Section D) | Henry Ford Health, $1,840/month gross, bi-weekly |
| Housing (Section G) | $950 rent, heat included, $85 electric |
| Child care (Section H) | $480/month, Bright Start Learning Center |
| Signature (Page 14) | Maria E. Lopez, 05/21/2026 |
Example 2: Robert and Janet Williams — Senior Couple Applying for FAP and Medicaid
| Form Section | What Robert and Janet Enter |
|---|---|
| Programs requested | Food Assistance, Healthcare Coverage |
| Head of household | ROBERT J WILLIAMS |
| Address | 812 OAK ST, GRAND RAPIDS MI 49503 |
| Household members | Robert Williams (72), Janet Williams (70) |
| Unearned income (Section E) | SSA Retirement: Robert $1,610, Janet $940 |
| Assets (Section F) | Fifth Third checking $1,800, 2014 Toyota Corolla |
| Housing | $725 mortgage, $180 property tax, gas heat $110 |
| Medical expenses (Section H) | Medicare Part B $349.40 combined, prescriptions $62 |
| Signature | Robert J. Williams, 05/21/2026 |
Example 3: Marcus Johnson — Recently Unemployed, Needs Expedited FAP and SER
| Form Section | What Marcus Enters |
|---|---|
| Programs requested | Food Assistance, Healthcare Coverage, State Emergency Relief |
| Head of household | MARCUS T JOHNSON |
| Address | 5601 LIVERNOIS AVE, DETROIT MI 48210 |
| Household members | Marcus Johnson (self, age 34) |
| Expedited screening (Section C) | Yes — gross income under $150 and cash under $100 |
| Earned income | None — laid off 04/30/2026 |
| Unearned income | Unemployment pending, $0 received yet |
| Housing | $650 rent, electric $385 past-due (shutoff 05/24/2026) |
| SER request (Section J) | Energy crisis, $385 needed, DTE notice attached |
| Signature | Marcus T. Johnson, 05/21/2026 |
How to File the Completed Form
You have four ways to submit DHS-1171, and the date of application — which controls when benefits start — is the date MDHHS receives a signed form with your name, address, and signature.
Online through MI Bridges. Go to newmibridges.michigan.gov, create an account, and complete the digital application. There is no fee, processing starts the same day, and you get a confirmation number on screen — print or screenshot it as proof of filing. Standard FAP/Medicaid decisions arrive within 30 days, expedited FAP within 7 days, and Medicaid for disability within 90 days.
By mail. Send the signed form to your local MDHHS county office. There is no fee and no required postage method, but Certified Mail with return receipt is smart proof of filing. Mail processing adds 3–5 days to the timeline. Keep a photocopy of the entire packet.
In person. Walk into your local MDHHS office during business hours, hand the form to the front desk, and ask for a date-stamped receipt copy. There is no fee. The receipt copy is your proof of filing and locks in your application date.
By fax. Fax numbers are listed on the county office page. There is no fee. Keep the fax confirmation sheet — it is your proof of filing. If the fax fails, the form is not filed, so call the office to confirm receipt.
No filing fees apply to any channel. Payment of benefits comes via the Michigan Bridge Card, which is mailed to you within 7 days of approval.
What Happens After You File
Within 1–3 days of filing, MDHHS sends a DHS-1153 Verification Checklist listing every document still needed. You have 10 days to return them, per BAM 130.
You will also be scheduled for a phone interview, usually within 7 days. The interview is required for FAP and FIP. Missing the interview without rescheduling causes an automatic denial. Medicaid alone does not require an interview under the Affordable Care Act streamlined eligibility rules.
If approved, your Bridge Card arrives by mail in about a week, pre-loaded with that month’s FAP benefits prorated from the application date. Medicaid coverage is retroactive up to 3 months before the application month if you had medical bills during that window.
If denied, you have 90 days to file a hearing request (DHS-18) under BAM 600. Hearings are held by phone before a state administrative law judge, and you can bring a Lakeshore Legal Aid or Michigan Legal Help advocate at no cost.
Mistakes to Avoid When Filling Out the Form
- Leaving the program checkboxes blank. The worker may screen you for one program only and miss the others, costing you weeks of benefits.
- Reporting net pay instead of gross. The agency uses gross income; net figures cause case discrepancies and verification holds.
- Forgetting the heat/utility checkbox. Missing this single check can shrink monthly FAP by $100 or more.
- Skipping the expedited screening boxes. Eligible filers wait 30 days for food instead of 7.
- Listing non-applying household members’ immigration status. It chills mixed-status families and is not required.
- Omitting a child you do not claim on taxes. FAP rules are not tax rules; missing a child reduces your benefit and is treated as misreporting.
- Failing to sign page 14. An unsigned rights and responsibilities page invalidates the whole form.
- Using white-out. Whited-out entries are treated as alterations and can flag the form for fraud review.
- Forgetting to date the signature. The agency cannot establish a filing date and may push your start month back.
- Ignoring the DHS-1153 verification checklist. Missing the 10-day deadline causes denial for failure to verify under BAM 130.
- Listing a disconnected phone number. No interview equals no benefits.
Do’s and Don’ts
Do’s
- Do file the form the moment you have a name, address, and signature, even with missing verifications, to lock in your application date.
- Do use blue or black ink in capital letters for legibility, since handwritten forms are scanned into the Bridges system.
- Do photocopy the entire packet before submitting, because lost mail is your problem to prove.
- Do ask for a date-stamped receipt at the office, since it is your only proof of filing if the form is misplaced.
- Do report changes within 10 days of approval under BAM 105, to avoid overpayments and IPV findings.
- Do call Michigan 2-1-1 if you need help with the form, because the service is free and confidential.
Don’ts
- Don’t lie or guess on income, because cross-matches with The Work Number and IRS data catch unreported wages.
- Don’t skip pages because they look like they do not apply — write N/A in fields you do not need to answer.
- Don’t wait until your shutoff date to apply for SER, because processing takes up to 10 days.
- Don’t sign a blank form for someone else, because forgery on a public benefits application is a felony.
- Don’t throw away the DHS-1153 checklist, since it is the roadmap to approval.
- Don’t ignore an interview call from a no caller ID number — MDHHS often calls from blocked lines.
Pros and Cons of Filing on Your Own vs. With Help
Pros of filing on your own
- You control the timing — no waiting for an appointment.
- It is free; no advocate fees ever apply.
- MI Bridges saves your progress so you can finish in chunks.
- You learn the system, which helps with renewals every 12 months.
- You keep full privacy without sharing details with a third party.
Cons of filing on your own
- It is easy to miss the heat checkbox or the medical deduction.
- You may not know to ask for retroactive Medicaid coverage.
- Mixed-status and disability cases are technical and easy to mis-code.
- Mistakes can take 30–90 days to fix on appeal.
- You may not know the difference between FAP household and tax household rules.
Pros of filing with help
- Free advocates from Michigan Legal Help and Lakeshore Legal Aid catch deductions you would miss.
- Hospitals and Federally Qualified Health Centers have certified application counselors at no cost.
- A trained navigator knows when to push for expedited FAP.
- Help-desk filers have lower denial rates in MDHHS internal data.
- An advocate can attend your hearing if you are denied.
Cons of filing with help
- You may wait 1–2 weeks for an appointment.
- You share private information with a third party.
- Some paid application services charge fees that are illegal under federal SNAP rules.
- Quality varies — community agencies are uneven.
- An over-eager advocate may push programs you do not want.
DHS-1171 vs. Common Companion Forms
| Form | Purpose |
|---|---|
| DHS-1171 | Master application for FAP, MA, FIP, CDC, SER |
| DHS-1010 Redetermination | Used at 12-month renewal, not first application |
| DHS-4583 Authorized Representative | Names someone to file on your behalf |
| DHS-1153 Verification Checklist | Lists documents owed after filing |
| DHS-18 Hearing Request | Appeals a denial within 90 days |
FAQs
Is DHS-1171 the same form for SNAP and Medicaid in Michigan?
Yes. DHS-1171 is Michigan’s combined application for FAP (SNAP), Medicaid, FIP, CDC, and SER, so one signed form covers every program at once.
Can I file DHS-1171 without a Social Security number?
Yes. You may apply, but every household member who wants FAP or FIP must provide an SSN or proof of application; Medicaid for kids does not require one.
Do I write my maiden name or my married name in Box 2?
No. Use whichever name appears on your current Social Security card, because MDHHS cross-checks names with SSA, and a mismatch holds the case.
Do I have to list my immigration status if I am not applying for myself?
No. Non-applying household members never have to disclose immigration status; write NOT APPLYING in their status box.
Can I leave Section C (expedited screening) blank if I am not in a rush?
No. Always answer it — if you qualify, you get FAP within 7 days at no extra cost, and skipping it only delays you.
Does my car count against me on the asset page?
No. One vehicle is exempt for FAP and Medicaid; only a second non-exempt car at fair market value over the limit counts.
Is there a fee to file DHS-1171?
No. Filing is free in every channel — online, mail, fax, or in person — and federal law forbids any agency or middleman from charging.
Can I apply if I am homeless and have no address?
Yes. Write HOMELESS in Box 3 and use a shelter, friend, or MDHHS office for mail; homelessness is not a bar to benefits.
How fast does MDHHS decide my application?
Yes, there are firm deadlines: 7 days for expedited FAP, 30 days for regular FAP and FIP, 45 days for most Medicaid, and 90 days for disability Medicaid.
Can I sign DHS-1171 electronically on MI Bridges?
Yes. Electronic signature on MI Bridges is legally equivalent to a wet signature under Michigan’s Uniform Electronic Transactions Act.
What if I make a mistake after I submit the form?
Yes, you can fix it — call your worker, submit a DHS-2240 Change Report, or update through MI Bridges within 10 days of noticing the error.
Can someone else fill out and sign DHS-1171 for me?
Yes. An authorized representative may sign with a completed DHS-4583; without that form, only the applicant’s signature is valid.
Will applying for FAP affect my immigration case?
No. Under current USCIS public charge rules, FAP, Medicaid (except long-term care), CDC, and SER are not counted against most immigrants.
Do I have to do an in-person interview?
No. Michigan conducts FAP and FIP interviews by phone; in-person interviews are only required if you specifically ask for one or if MDHHS cannot reach you.
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