Forms & Waivers

Forms and Waivers

JFS 07216 Healthy Start/Healthy Families Combined Program Application Download
JFS-07221 Supplemental Nutrition Assistance Program (SNAP) Interim Report Download
JFS-07200 Application for Cash, Food, or Medical Assistance Download
JFS-03804 Ohio Works First / Supplemental Nutrition Assistance Program (SNAP) Sanction Compliance Agreement Download

PRC Application For Vehicle Repairs and Job Related Supportive Services Checklist

Online benefit application tool for food assistance

When turning in applications or supporting documents for verifications:

  1. Email information to Gallia-documents@jfs.ohio.gov
  2. Fax information to 740-441-2108
  3. Mail information to: Gallia County Department of Job and Family Services, 848 Third Avenue, Gallipolis, Ohio 45631
  4. Drop off at our Drop Box outside the DJFS Building