Interview Notice
Form 08AD091E v.1 11/01/2012 Page 1 of 2
Notice Information
Date
Case name
Case #
County #
Supervisor # Worker #
Before you receive or continue to receive
benefits, you must be interviewed.
date time
Telephone number we will use to call you:
You can speed up the eligibility process by providing copies of proof listed on the back of this
form that apply to your circumstances. Copies of proof may be faxed to
or mailed to the OKDHS address at the top of this form before your scheduled interview or you may
bring copies at the time of your interview.
Your interview is scheduled in our office on:
Your interview is scheduled by telephone on:
to reschedule your interview.
If you cannot keep this appointment or want us to call you at a different telephone number, contact us
at
to reschedule your interview.
If you cannot keep this appointment or want to schedule a telephone interview, contact us at
Benefits may be delayed or denied if you are not available for this interview and do not Interview Notice
Form 08AD091E v.1 11/01/2012 Page 1 of 2
Notice Information
Date
Case name
Case #
County #
Supervisor # Worker #
Before you receive or continue to receive
benefits, you must be interviewed.
date time
Telephone number we will use to call you:
You can speed up the eligibility process by providing copies of proof listed on the back of this
form that apply to your circumstances. Copies of proof may be faxed to
or mailed to the OKDHS address at the top of this form before your scheduled interview or you may
bring copies at the time of your interview.
Your interview is scheduled in our office on:
Your interview is scheduled by telephone on:
to reschedule your interview.
If you cannot keep this appointment or want us to call you at a different telephone number, contact us
at
to reschedule your interview.
If you cannot keep this appointment or want to schedule a telephone interview, contact us at
Benefits may be delayed or denied if you are not available for this interview and do not
