Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: OBSOLETING EMPLOYER AND STUDENT INCOME VERIFICATION FORMS
MANUAL REVISION #
FORM REVISION #
FA-311 obsolete
FA-321 obsolete
IM-12 obsolete
IM12A obsolete
IM-108 obsolete
DISCUSSION:
Effective 5/28/2022, the following employer and student income verification forms are obsolete for all Income Maintenance (IM) programs:
• Manual forms removed from the internal and external forms manuals: IM-12, IM-12A, and IM-108
• System forms removed as options to send by the eligibility systems: FA-311, FA-321, IM-12, and IM-108
The following Supplemental Nutrition Assistance Program (SNAP) policy sections are updated to remove references to the obsoleted forms:
• 1102.015.05 Gross Income
• 1102.015.45 Number of Hours Worked by Able Bodied Adults Without Dependents
To assist participants in obtaining verification staff should do the following:
• Complete a telephone call with the employer and/or participant
• Use electronic sources when applicable
• Communicate what are acceptable documents to be used as verification
o Language should be clear and concise
When generating a request for information (FA325 or IM31A), the form should be edited to include clear and concise details of the required verification as well as the specific time period needed.
NECESSARY ACTION:
• Review this memorandum with appropriate staff.
KE/ams