The IM-2, Application for Food Stamp Benefits and Eligibility Statement, is being revised.  The revised IM-2 will contain complete fraud provision information. Until the revised IM-2 is available to staff, please line out reference to the Notification and Acknowledgement of Fraud Provisions in bullet five on page 7 of the current IM-2 (03/95).

 NOTE:  The IM-3 is not required for MC+, Medicaid, or adult  cash assistance applications.

Change reporting is imperative to achieving our goal of correct benefit delivery. Staff must review the IM-3 with the household at every application and reapplication.  Discussion of the IM-3 is required during a telephone interview as well as at in-person interviews.  The household receives a copy of the IM-3 at the in-person interview or, when a phone interview is conducted, the IM-3 is mailed with the approval letter. Do not delay processing an application pending receipt of a signed IM-3.

The IM-3 form is the primary evidence presented at food stamp and Temporary Assistance administrative hearings to prove the household was informed of his/her responsibility to report changes.  When the IM-3 is mailed to the household, staff must ensure the copy of the IM-3 filed in the record indicates the form was sent to the household and the date it was sent.

The back of the IM-3 informs the household of the Child Protection Clause.  Staff is expected to discuss the Child Protection Clause with Temporary Assistance applicants.  Refer to Memorandum IM-#157 dated December 2, 1998.

Attached is a copy of the revised IM-3 and its instructions.
Use normal procedures to order the revised IM-3 (05/00) from the warehouse.  Upon receipt of the revised IM-3 (05/00), destroy/recycle IM-3 forms with the revision date of 10/95 or earlier and the IM-3 instructions dated (03/91).

Discuss the IM-3, Changes You Must Report, with the household at every application and reapplication.

 

Give or mail a copy of the IM-3 to the household.

 

Discuss the Child Protection Clause with Temporary Assistance applicants.

 

Refer to the FS-1 or IM-2 (after revision), for legal references and quotes concerning change reporting and fraud provisions.

 

Destroy/recycle the IM-3 (10/95) with instructions (03/91) and file the revised IM-3 (05/00) with instructions in the IM Forms Manual.