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The first paragraph, which explains household rights, is updated to include that the household may fax the food stamp application to the county office.

The expedited service section is changed to instruct staff to conduct an interview in person or by phone according to policy.  The worker writes the date the interview was held on the bottom line of the page.  The interview can be postponed if the applicant has no telephone and is expedited eligible.

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HOUSEHOLD MEMBERS:  A statement regarding submission of the social security number and immigration status is revised to inform households this information is voluntary and failure to provide this information results in ineligibility for the individual for whom the information is not provided.  Households are also informed the SSNs and immigration status information that is provided is used and disclosed in the same manner as that of included household members.

Two columns are added for the applicant to indicate "yes" or "no" if s/he is Hispanic.  The race/sex column is added for the applicant to indicate the race and gender of the household member.  The race codes are listed at the bottom of this section.  This is to align the application with current procedures regarding race/ethnicity.

RESOURCES:  We added "Certificates of Deposit" to the list of possible resources.  In the resource section "balance/value" is changed to "amount".

EARNED INCOME:  Question A asks the applicant if s/he or anyone receives income from employment.  Questions B1 and B2 are added to ask if anyone in the household has started working, if the individual has received a paycheck, and if anyone in the household works overtime.  If "yes", s/he is asked to list the individual with the overtime, and how often the overtime is worked.  Questions C, D, and E are only re-labeled.

UNEARNED INCOME:  Question A is changed to clarify if anyone in the household has income other than from employment and asks the applicant to list the amount from each source checked.  Retirement benefits are added as a possible source of unearned income.

SHELTER EXPENSES:  Question B is changed to ask if someone else pays all or part of the household's utility costs.

NON-DISCRIMINATION AND FAIR HEARING RIGHTS/PRIVACY ACT STATEMENT:  This section is updated with the revised language received from the United States Department of Agriculture (USDA).

IMMIGRATION STATEMENT:  The immigration statement informs the household that the Immigration and Naturalization Service (INS) may be contacted for verification of immigration status.  It informs the household s/he may exclude the ineligible immigrant from the household.  The title of this section is renamed from Alien Status.

SIGNATURE:  In the first sentence, the words "for whom I am applying" are added.

The FS-1 form instructions are revised and attached to this memorandum.

Use the current FS-1 (08/99) to depletion.  Order the revised FS-1 (02/02) from the warehouse.  A large volume of the application is being produced to prevent copying the application for office use.

• Discuss this memorandum with appropriate staff.

• Review the attached FS-1 form and instructions with all appropriate staff.

• Use the current supply of the FS-1 (08/99) to depletion.

• Order the revised FS-1 (02/02) from the warehouse using normal ordering procedures.

• File the revised FS-1 (02/02) and form instructions in the IM Forms Manual.