The Washington AF 595 form is an essential document utilized by the Washington County Department of Job and Family Services to assess an individual's eligibility for public assistance benefits. This form requires detailed information about employment history, including the dates of employment, reasons for termination, and gross earnings over specified pay periods. It serves as a tool for both applicants and employers, ensuring that all necessary information is reported accurately and comprehensively. Individuals filling out the form must acknowledge their responsibility to provide truthful information, as any discrepancies may lead to legal consequences. The document also includes sections for employers to complete, highlighting key employment details that contribute to the eligibility determination process. By collecting this information, the AF 595 form plays a crucial role in facilitating access to vital assistance programs such as Aid to Dependent Children (ADC), Medicaid, and Food Stamps, among others.