Cancel
Additional Household Member Details.
| Applied for SSN | SSN | ||||
|---|---|---|---|---|---|
| Citizen Status | Member Start Date |
|
Race Details
| Black Or African American | White Or Caucasian | ||
|---|---|---|---|
| Native Alaskan Or American Indian | Native Hawaiian Or Pacific Islander | ||
| Asian |
Additional Details
| Does the new household member have a Primary Caretaker (other than a parent), who is an existing household member? |
|---|