Temporary Eligibility Due To Missing Proofs - 633A - English/Spanish
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Description: WIC is required to see proof of income, residency, and identity to provide WIC services. If you cannot show proof for income, residency, and/or identity, you may fill out this form with the required information. This allows you to receive food benefits for the current month.
Format: This document is a 2-sided handout, 8.5" x 11" with English on one side and Spanish on the other. There is a "Large Print" version of this available as well in both languages for digital download only.
Packaging: These documents come in shrink wrapped packs of 100.
Languages Available: English/Spanish , Large Print English, Large Print Spanish
Form number: 633A
Revision date: 01/2025