740-695-1075 Belmont County - St. Clairsville, Ohio

Assistance Applications and Forms

You can now apply by phone. Call 1 (844) 640-OHIO (6446) to apply for Supplemental Nutrition Assistance Program (SNAP), Cash assistance (Temporary Assistance to Needy Families), and Medicaid. An audio signature will be required if you apply by phone.

All printed applications can be submitted, in person, to our office. Applications can also be mailed to:

Belmont County DJFS
68145 Hammond Rd.
St. Clairsville, OH  43950

If you need an application mailed to you, please call (740) 695-1075, extension 1130 or you can also click on one of the specific links listed below and submit the printed application to the BCDJFS.

Click on the application for the type of assistance you are seeking

Application for Cash, Supplemental Nutrition Assistance Program (SNAP), and/or Medicaid Benefits

(Click here for Application in Spanish)

Application for Health Coverage – ONLY

(Click here for Application in Spanish)

Application for Publicly Funded Child Care

Complete and print out the application

BRING THE COMPLETED APPLICATION TO OUR OFFICE

OR MAIL TO:

Belmont County DJFS
68145 Hammond Rd.
St. Clairsville, OH  43950

OR FAX TO: (740) 695-5251

COMMONLY USED FORMS

SNAP Interim Report

SNAP / FOOD ASSISTANCE CHANGE REPORT FORM

Authorized Representative Form for ALL PROGRAMS

Authorized Representative Designation Form for Medicaid ONLY

NewFraud Warning

NewMedicaid Rights and Responsibilities

NewCash and SNAP Rights and Responsibilities

NewABAWD OAC Rules

NewSNAP E&T OAC Rules

NewJOBS Rights and Responsibilities

All printed forms and verifications may be submitted in person at our office at 68145 Hammond Rd., St. Clairsville, OH 43950. Applications may also be mailed to the same address or faxed to (740) 695-5251.

Belmont County DJFS
68145 Hammond Rd.
St. Clairsville, OH  43950 

Or fax to:  (740) 695-5251