Missouri Department of Social Services, Family Support Division — Application for Supplemental Nutrition Assistance Program (SNAP) (MO 886-0460 / FS-1) Completed Form Examples and Samples
Find detailed examples and samples of the Missouri Department of Social Services, Family Support Division — Application for Supplemental Nutrition Assistance Program (SNAP) (Form MO 886-0460 / FS-1). Our filled-out form examples help you correctly complete your Missouri SNAP application for food assistance.
Missouri SNAP Application (FS-1) Example for a Single-Parent Household
How this form was filled:
This is an example of a completed Missouri SNAP Application (Form FS-1) for a single mother, Maria Garcia, who recently lost her job and is applying for food assistance for herself and her two young children. The form details the household composition, lack of earned income, minimal assets, and essential living expenses like rent and utilities.
Information used to fill out the document:
- Case Name: Maria Garcia
- Applicant Name: Maria Garcia
- Home Address: 456 Oak Avenue, Apt 2B, Kansas City, MO 64108
- Mailing Address: 456 Oak Avenue, Apt 2B, Kansas City, MO 64108
- Phone Number: 816-555-0123
- Household Size: 3
- Head of Household: Maria Garcia, DOB: 07/15/1996, SSN: 987-65-4321, US Citizen
- Household Member 2: Leo Garcia (Son), DOB: 03/22/2019, SSN: 123-45-6789, US Citizen
- Household Member 3: Sofia Garcia (Daughter), DOB: 05/10/2022, SSN: 234-56-7890, US Citizen
- Income Status: Unemployed. Last day of work was April 15, 2026. Receiving unemployment benefits of $320 per week.
- Assets/Resources: Checking Account: $450, 2015 Honda Civic
- Monthly Rent/Mortgage: $850
- Utility Expenses: Heating/Cooling: $120/month (average), Electricity: $75/month
- Child Care Expenses: $0 (cared for by a relative for free)
- Signature: Maria Garcia
- Application Date: 05/10/2026
What this filled form sample shows:
- Complete information for a three-person household, including a single adult and two minor children.
- Clear declaration of recent job loss and current income from unemployment benefits.
- Accurate reporting of essential household expenses like rent and utilities to determine eligibility.
- Properly filled out personal details for all members, including full names, dates of birth, and Social Security Numbers.
- Designation of an authorized representative is left blank, as the applicant is applying for herself.
Form specifications and details:
| Form Name: | Application for Supplemental Nutrition Assistance Program (SNAP) |
| Form Number: | MO 886-0460 / FS-1 |
| State: | Missouri |
| Agency: | Department of Social Services, Family Support Division |
| Use Case: | Single parent with two children, recently unemployed and applying for food assistance. |
Created: February 03, 2026 07:56 PM
