This list was published on June 28, 2021.
This form is used to request a change in the financial contribution amount required for an adult being accommodated via an intermediate resource. For instructions for completing the form, use the Guide to the Application for exemption.
Form 4475
Instructions for completing the form Application for Exemption or for Re-Evaluation.
Guide 3918
This list was published on March 2, 2022.
This list was published on May 25, 2022.
This list was published on June 22, 2022.
