IM-81 05/25/00 IM-3, CHANGES YOU MUST REPORT FORMS MANUAL REV.
|IM-3, CHANGES YOU MUST REPORT
FORMS MANUAL REVISION #16: FORM IM-3
|The IM-3 is revised to make it a notice
of change reporting responsibilities for food stamps and Temporary Assistance.
The legal references and language pertaining to fraud were removed from
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.
Form not available online hard copy only