Common Forms
Budgeting
Interfaces
Common Forms Part II
Other Random Things
100
This form is used as the main form when pending for additional information.
What is a 2429 - Insufficient Information Form
100
This is the command used to double check your shelter expenses are correct in your SNAP Budget. It is checked on the FS3 screen in your budget.
What is SHEL?
100
This interface is used to check income, unemployment and can also verify vital statistics for household members.
What is ANSWERS?
100
This form is completed by current or former employer to verify earnings, employment status, termination or leave of absence, reason job ended, and medical insurance.
What is a 2074 - Earnings Verification form
100
This is mandatory to track and especially important during election years.
What is Voter Registration?
200
This form is to be completed by the client when receiving assistance through TANF, SNAP or Medicaid and they want to add a new member to their assistance unit.
What is a 2109 - Addition to the Assistance Unit Form
200
This is the command used to double check your medical expenses are correct in your SNAP Budget. It is checked on the FS3 screen in your budget.
What is FMED?
200
This interface is used to determine if clients are paying or receiving child support.
What is LEDGRS?
200
This is used to authorize a representative to act on the client’s behalf in providing all the necessary information to determine eligibility for assistance. It is completed and signed by both the client and the representative.
What is a 2425 - Designated Authorized Representative form
200
These two programs give prorated benefits when processed after the application date.
What are TANF and SNAP?
300
This form is used to document that the household has received training on the use of the EBT system. The client checks off each box and signs to show they understand their responsibilities in relation to EBT. The form is used to authorize card issuance and issue a card and PIN to the household.
What is a 2321 - EBT Benefits Issuance Authorization form
300
When establishing your 30/60 day history for a best estimate this is the date that is used.
What is the date before the date of application?
300
This interface is used to identify if a client is receiving social security income.
What is SOLQ?
300
Completed by the clients to report any changes.
What is a 2584 - Change Report Form
300
PPV stands for this and is used when expediting a SNAP case. It also requires a "P" (instead of an "N") on any screens that you may be requesting additional information on.
What is Posted Poned Verifications?
400
This form is completed by all people who are giving or lending the client money. It can also be used as verification of medical insurance provided for clients.
What is a 2506 - Cash Contribution Verification form
400
When budgeting child support expense a worker must use this look back period per E&P Manual 660.4.3 when a record of three or more consecutive months of paid, legally obligated support has been established.
What is the average of at least three months of payments?
400
This interface is used to submit a referral to the investigations team when potential client fraud is suspected.
What is IRIS?
400
Completed and signed by all TANF clients and used to gather information on the non-custodial parent (NCP). A copy is sent to the CSEP office. One form is needed for every NCP.
What is a 2906 - Non-Custodial parent form
400
This is the number of days used when requesting for additional information.
What is 10?
500
This form is completed by the school to verify status and financial aid for a student of higher education. This is NOT used to verify school attendance for children.
What is a 2020 - Student Income Verification form.
500
A person under this age who is living with their parents must be included as one household and cannot claim separate food unit status for the SNAP program.
What is 22?
500
This interface can be used to establish CIT/ID for clients, but only if a medical case is attached.
What is FHUB?
500
Signed by both the client and worker to notify to all applicants of the MER Program. The form must be included with applications for MAABD.
What is a 6160 - Medicaid Estate Recovery Noritifacation
500
When an action requires adverse this is the number of days required to notify the client.
What is 13 days?