Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: UPDATED CHANGE REPORT (IM-145)
FORM REVISION #
IM-145
IM-145B obsolete
DISCUSSION:
The IM-145 has been updated and is to be used for all Family Support Division (FSD) programs.
Changes to the IM-145 include:
- Clearer fields for participant information.
- New fields for participants to close any FSD case for the household, or to remove a participant from an active case.
- Clearer field for participants to add a person to an active case.
- A new field for participants with an active MO HealthNet (MHN) case to request new or different MHN coverage.
- Clearer fields to report changes in child support expenses, dependent care expenses, and health insurance expenses.
- Updated language to allow the participant to sign with an electronic signature.
The revised IM-145 shows a revision date of 1/2023. All versions of the IM-145 with a different revision date are now obsolete. The obsolete forms may still be accepted as valid, but staff should begin using the revised form and encourage community partners to do the same.
Report a Change, online form on myDSS.mo.gov has been updated to reflect the revisions.
The IM-145 is updated in the public forms manual and the internal forms manual.
The Change Report (Income only) (IM-145B) form is now obsolete. Participants reporting change of income should use the IM-145 and only complete the necessary sections.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Begin using IM-145 with 1/2023 revision date immediately.
- Discard and destroy blank IM-145 forms with older revision dates.
- Discard and destroy blank IM-145B forms.
- Share with community partners and contacts.
KE/cj