Income verification (attached documentation to application)
Wages 4 current and consecutive pay stubs
Unemployment Compensation One month's worth of pays stubs
TANF, SSI, Social Security, Veterans Pension, General Assistance, Dividends/Interest Rental Income, Retirement Pension, Child Support / Alimony, Other Income Copy of check(s), check stub(s), or bank statement showing direct deposit. One month's worth of verification required.
PLEASE MAIL THIS APPLICATION ALONG WITH THE NECESSARY INCOME VERIFICATION TO:
Regional Transportation Program
1 Ledgeview Dr
Westbrook, ME 04092
Or you can bring it into our office at 1 Ledgeview Dr, Westbrook Monday through Friday 8:00am to 4:00pm
HEARING RIGHTS
If you are not satisfied with a decision made regarding your eligibility for the provision of social services, you have the right to ask for a hearing before the commissioner of the Department of Human Services or his agent. If you want an informal conference with the Regional Director or the Provider Agency or his agent, you should request it within ten (10) days of the notice of the action by contacting the office where you made application for or received the service. If you want a formal hearing, you must request it by contacting the same office or the Commissioner of the Department of Human Services, State House Station #11, Augusta, Maine 04333. A request for a formal hearing must be made within thirty (30) days of the effective date of the notice of the action you wish to appeal. If you request either type of hearing within (10) days of the date of the notice regarding your eligibility for or the provision of social services, the proposed action will not go into effect until your appeal has been heard and a decision rendered.
CIVIL RIGHTS NOTICE
If you feel you have been discriminated against because of your race, color or national origin, you may file a complaint requesting a hearing on this matter with a Regional or the State Office of the Department of Human Services or with the U.S. Department of Health, Education and Welfare, Washington D.C.
REPORTING RESPONSIBILITIES
REMEMBER! It is your responsibility to report to the agency providing the social service to you all changes in your circumstances which could affect your eligibility for the services. Should you receive benefits to which you are not entitled due to failure to report changes promptly and correctly, you will be expected to repay any benefits for which you were not eligible.
FRAUDULENT REPRESENTATION
The willing acceptance and/or use of any State and/or Federal funds under this program for which a person knowingly is not eligible may constitute fraud and subject the user to prosecution under penalties of law.