The document is a receipt from a library branch verifying that documents related to a customer's case with HCJFS (Hamilton County Job and Family Services) were scanned and transferred. It lists various documents provided by the customer about their family, health, income/resources, residence, children, and job/benefits. The customer and library staff sign to verify the documents checked were scanned, and the customer is advised to contact HCJFS if they don't hear about their case within 10 days.