Submit Benefit Access Assistance - Disabilities Request


Reporter (leave blank to submit anonymously)

Enter as 999-999-9999

Benefit Access Assistance - Disabilities

This service request should be used to request assistance while applying, reapplying, or checking on a Benefit Access Application. This program is only available to people 59 years of age and under.

Instructions

Describe the issue you wish to report including a photo and/or a description.
* Indicates a required field.