Attached to this memorandum is the revised
form IM-3, Changes You Must Report. Changes made to the form are
listed below.
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The overall layout of the IM-3 is changed
into three program sections which provide program specific changes to report
in one section rather than throughout the form.
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Both the "Change in Income Source and "Change
in Gross Monthly Income" sections for all three programs are revised to
include the statement "but not limited to". The purpose for this
change is to clarify the income listed is not all inclusive. The
income listed in both sections are examples of the most common income received
by a household.
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A statement is added in both income sections
for all three programs that households who are unsure what to report must
contact their worker.
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The wording of the section "Change in Any
Asset" for the Food Stamp Program is changed to clarify asset limits.
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The section "Change in Residence and Resulting
Change in Shelter Costs" for the Food Stamp Program is changed to read
"Change in Address and Resulting Change in Shelter Costs".
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In the "Change in Household Members" section
for all three programs we added the household should report receipt of
a social security number for a household member.
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The "Gain or Loss of a Vehicle (Licensed or
Unlicensed)" is removed from the food stamp section as it does not apply
to the Food Stamp Program.
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We are emphasizing the need for households
to report changes within ten days. This is accomplished by using
bold letters and italics for the words "within ten days" at the top of
the page as well as in the "Agreement to Report" section.
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In the child care section, a statement is
added for the household to report if there is a change in the time of day
child care is provided.
During an initial or recertification food
stamp application interview, explain the change reporting requirement that
appears to be applicable to the household as outlined in Memorandum
IM-#76 dated 04/18/01. Give the IM-3 to households who are not
subject to the earned income household reporting requirements and earned
income households making application for food stamps in combination with
another program. Provide a copy of the IM-3 to all applicants for
Temporary Assistance and/or child care.
An initial distribution will be sent to
each county office. Upon receipt of the revised IM-3 (02/02) destroy/recycle
all versions from 05/00 back. Staff may order the revised IM-3 (02/02)
from the warehouse. |