To encourage applicants to complete all the questions on the IM-2, the "yes/no" responses are now in bold print.  A summary   of other revisions follows.  Refer to the revised form instructions for more specific information regarding revisions to the IM-2.

SUMMARY OF CHANGES

FORM TITLE:  The first page of the IM-2 is renamed "APPLICANT'S ELIGIBILITY STATEMENT". 

BENEFIT SECURITY® CARD:  This section is added to assist staff in replacing Benefit Security® Cards.  The reasons listed are those used on the EBT Desk Reference Sheet which contains the EBT status codes.  This section has been moved into the eligibility statement and is located with Direct Deposit.

NON CITIZEN:  An additional question is added to this section regarding citizenship and provides space for the applicant to list non-citizens.

HOUSEHOLD'S DECLARATION INQUIRY:  This section is added to the IM-2 which eliminates the need to use the FS-1/IM-2 attachment with the IM-2 eligibility statement.  Continue use of the
FS-1/IM-2 attachment when completing a Temporary Assistance reinvestigation using the Modified IM-2 form.

INCOME:  The income section is revised to separate earned and unearned income.  Common sources of unearned income are listed for the applicant to check the appropriate box and enter the amount received. 

DEPENDENT CARE EXPENSE:  This section now includes the Child Protection Clause.  The Child Protection Clause is designed to promote parental choice in child care decisions.  This policy applies to any household where the individual is a single custodial caretaker caring for a child and is unable to obtain appropriate, suitable, and/or affordable child care.  The section is revised to include mileage costs and the number of trips per week to and from the day care provider.

RESOURCES:  Trust fund is added to the line with annuities.

TRANSFER OF PROPERTY OR RESOURCES:  A question is added asking the applicant or spouse if either has created, or been a party of, a trust within the past five years. 

LIFE INSURANCE OR BURIAL PLAN:  The insurance categories are separated into two sections, life insurance/burial plans and health insurance. 

HEALTH INSURANCE:  This section includes information regarding types of coverage related to the MC+ program.

DIRECT DEPOSIT:  This section is better identified for the applicant to indicate whether or not he/she wishes to have direct deposit for Temporary Assistance grants.

TEMPORARY ASSISTANCE, MC+, MC+ FOR PREGNANT WOMEN:  Additions to this section include questions that pertain to the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.

The Unemployed Parent section is changed to ask questions of a two-parent family.

CHILD SUPPORT EXPENSE:  Wording is changed for the applicant to include arrearages and health insurance payments for
non-household members.

COMMENTS/ADDITIONAL INFORMATION:  This area is available for use by staff to make additional comments or record additional information obtained during the interview.

NOTIFICATION AND ACKNOWLEDGEMENT OF FRAUD PROVISIONS:  This section is revised to include changes in the penalty provisions.  Discuss this information, along with the Non-Discrimination information, with the applicant to ensure the household is notified regarding its responsibilities as a participant in the assistance programs available to him/her. 

An initial distribution of the revised IM-2 will be sent to the county offices.  When FAMIS Food Stamps is implemented in your county, destroy the IM-2 dated (03/95).

• Review this memorandum and instructions with all appropriate staff.

•  Use the FS-1/IM-2 Attachment ONLY when completing a Temporary Assistance reinvestigation using the Mod-2.

• Destroy IM-2 (03/95) when FAMIS is implemented in your county.  Until then continue to use current supply of IM-2 (03/95).

• File the revised form IM-2 (09/02) with instructions in the IM Forms Manual.

• Destroy all IM-2 instructions with a revision date prior to April 2002 upon FAMIS implementation.