HCJFS 2326 - Affidavit for Identity of Children
for Medicaid, Ohio Direction Card (food assistance), Ohio Works First
 


 
(1) Print the form (click on the link below)
Note: You will need to print one form for each person you are applying for.
 
(2) Complete the information on the entire form.
 
(3) If you don't know your caseworker's name, district number or fax number, please call (513) 946-1000 and an Information and Referral Specialist will assist you.
 
(4)You may return the form by mailing it or dropping it off at one of our Document Drop Off Centers located at 222 East Central Parkway. You can also fax it to us free of charge at any branch of the Public Library of Cincinnati and Hamilton County. Or fax from any other location to (513) 946-1076.

HCJFS 2326 - Affidavit for Identity of Children (pdf)