M E M O R A N D U M

IM-38  03/27/02  DISTRIBUTION OF FORM IM-110
FOOD STAMP MANUAL REVISION #13
SECTION 1150.010.00
SECTION 1150.010.05
FORMS MANUAL REVISION #7
IM-110 STATEMENT OF LOSS/REPLACEMENT REQUEST


SUBJECT:
DISTRIBUTION OF FORM IM-110
FOOD STAMP MANUAL REVISION #13
SECTION 1150.010.00
SECTION 1150.010.05
FORMS MANUAL REVISION #7
IM-110 STATEMENT OF LOSS/REPLACEMENT REQUEST
 
DISCUSSION:
Effective immediately, the distribution of Form IM-110 Statement of Loss/Replacement Request is changed.  Continue to file the original form in the case record.  Send the pink copy to the Food Stamp Program and Policy Unit in Central Office.  Do not send a copy to the Food Assistance Program Office.

There is no change to the procedure for replacing benefits when food purchased with food stamp benefits is lost in a household misfortune.  The county office makes the determination regarding the amount of food stamp benefits to replace and enters the FISU replacement request using the reason code "K".  The county then completes the lower portion of the IM-110 and sends the copy to the Food Stamp Program and Policy Unit.  The Food Stamp Program and Policy Unit uses the copy to check incidences of duplicate issuances and for investigative purposes.

If the replacement is denied, inform the household of the denial and the reason for denial.  Although this is not a policy change, the Food Stamp Manual is revised to specify this provision.

The Food Stamp Manual and the Forms Manual are revised to show the correct unit to which the completed IM-110 is sent.

NOTE:  Form IM-110 is not revised at this time.
NECESSARY ACTION:
  • Discuss this memorandum with all appropriate staff.
  • File the revised manual pages in the hard copy of the Food Stamp Manual. 
  • File the revised Forms Manual pages in the hard copy of the Forms Manual. 
MRT
Distribution #6
Revised Forms Manual pages (pdf)
IM-37
[ 2002 Memorandums ]
 IM-39