Family Support Program Application Instructions

Required With Every Application (New and Returning):

Family Support Program Application: Completed, signed and dated.

Documentation of Residency in Rutherford County: Acceptable documentation would include copy of a current utility (gas, water, or electric) statement or government document with the name of the applicant (or applicant’s head of household) showing the applicant’s street/home address. Document must be dated within the last 60 days. Please note: Post Office Box addresses are not acceptable evidence of residency, neither are bank, credit card statements or medical bills.

Required With New Applications (U. S. Citizens Only):

Copy of United States Birth Certificate. Once you have supplied a U.S. Birth Certificate to the Family Support Program, you do not have to send a copy with subsequent applications.

Required with Every Application (U. S. Resident Non-Citizens Only)

Documentation of Qualified Alien Status (any of the documents below). This is required each year along with your application:

                A valid, unexpired US Passport or US Passport Card

                A United States certificate of birth abroad (DS-1350 ir FS-545)

                A report of birth abroad of a citizen of the United States (FS-240)

                Certificate of Citizenship (N560 or N561)

                Certificate of Naturalization (N550,N570, or N578)

                A United States citizen identification card (I-197, 1-179)

Applicants who claim qualified alien status may contact the State or Regional Family Support Offices, (State, phone 615-532-6552, Regional, 615-231-5057) for clarification on required documentation.

Required With All New Applications and Updated as Requested by the Family Support Program:

Documentation of Disability: A recent letter or statement from your physician that describes your disability and explains specifically how your life activities are limited. Note that if the disability documentation you submit does not include adequate detail about your limitations additional information may be requested.  Statements obtained from urgent care/walk-in clinics will not be accepted. Eligibility for the Family Support Program is not based on the receipt of Social Security Disability benefits.

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