[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-288132-105":53,"doc-detail-288132-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","no-income-verification-letter-virginia-ryan-white-part-b-program","No Income Verification Letter - Virginia Ryan White Part B Program","","This document serves as an official No Income Verification Letter for the Commonwealth of Virginia Department of Health, specifically for the Virginia Ryan White Part B Program. It is designed for individuals seeking medication assistance who have no verifiable income. The letter requires a third-party supporter to attest to the applicant's financial status, confirming they provide either food and shelter or ongoing financial support. The form captures essential supporter details, including contact information, relationship to the applicant, and a formal certification signature, ensuring program eligibility requirements are met through the Provide Enterprise system. This template facilitates the necessary verification process for applicants requiring aid while maintaining strict oversight and accountability standards for public health resource distribution.",{"@graph":63,"@context":122},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/no-income-verification-letter-virginia-ryan-white-part-b-program/288132/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/no-income-verification-letter-virginia-ryan-white-part-b-program/288132.png","ImageObject",442,249,{"name":88,"@type":89},"Riley West","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-19","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":73},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114,118],{"name":105,"@type":106,"acceptedAnswer":107},"What is the purpose of the No Income Verification Letter?","Question",{"text":108,"@type":109},"It is used by the Virginia Ryan White Part B Program to certify that an applicant has no income and is receiving support from another individual to qualify for medication assistance.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Who can sign this verification letter?",{"text":113,"@type":109},"The letter should be signed by the person providing support, such as a friend or family member, who is supplying the applicant with food, shelter, or financial aid.",{"name":115,"@type":106,"acceptedAnswer":116},"What information must the supporter provide?",{"text":117,"@type":109},"The supporter must provide their name, address, telephone number, relationship to the applicant, a signature, and the date, as well as specify whether they provide food, shelter, or financial support.",{"name":119,"@type":106,"acceptedAnswer":120},"Where should the completed form be submitted?",{"text":121,"@type":109},"The completed document must be uploaded into the Provide Enterprise system.","https://schema.org",{"og:url":78,"og:type":124,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":126,"canonical":78},"index,follow",{"doc_id":128,"site_id":56},288132,1789633152,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":88,"user_avatar":133,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":73,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":139,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":61,"update_tm":129,"read_time":4},1099523885074,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","COMMONWEALTH of VIRGINIA  \nDepartment of Health  \nVirginia Ryan White Part B Program  \nNo Income Verification Letter  \nI understand that   is receiving medication assistance  \nName of Applicant  \nfrom the Virginia Department of Health (VDH) . To the best of my knowledge, the applicant has no income and I certify this to be true. I am either providing the applicant with food and shelter or providing the applicant with financial support.  \n(My relationship to the applicant-for example: friend, cousin)  \nI am providing (check one):  \n􀀀 Food and Shelter  \n􀀀 Financial Support $  approximate amount per month  \n\n| Signature of person providing support |\n| --- |\n| Address |\n\nTelephone number  \nPrinted name of person providing support  \nDate  \nIf you have any questions, please contact the Eligibility & Medication Call Center at 1-855-362-0658. Please upload this document into the Provide Enterprise system.","cbCaiiaGSZx6gF5V","https://ap.wps.com/l/cbCaiiaGSZx6gF5V","pdf",289261,"English","# No Income Verification Letter\n## Supporter Certification\n## Contact and Submission Information","[{\"question\":\"What is the purpose of the No Income Verification Letter?\",\"answer\":\"It is used by the Virginia Ryan White Part B Program to certify that an applicant has no income and is receiving support from another individual to qualify for medication assistance.\"},{\"question\":\"Who can sign this verification letter?\",\"answer\":\"The letter should be signed by the person providing support, such as a friend or family member, who is supplying the applicant with food, shelter, or financial aid.\"},{\"question\":\"What information must the supporter provide?\",\"answer\":\"The supporter must provide their name, address, telephone number, relationship to the applicant, a signature, and the date, as well as specify whether they provide food, shelter, or financial support.\"},{\"question\":\"Where should the completed form be submitted?\",\"answer\":\"The completed document must be uploaded into the Provide Enterprise system.\"}]","No Income Verification Letter - Virginia Ryan White Part B Program | PDF"]