Request To Add Family Member


Head of Household



Person You Wish To Add

Please complete the following to add a family member. Completion of this form does not guarantee that the request will be granted. You will receive a written response regarding the approval or denial of this request.


Documents Needed

A background check will be conducted on anyone 18 and over to verify that they have no criminal history before request will be considered.
I declare under penalty of perjury, that the above information is true and complete.

WARNING: Title 18, Section 1001 of the United States Code, states that a person who knowingly makes false or fraudulent statements to any department or agency of the United States is guilty of a felony.