SUBJECT:
FORM IM-89, AGENCY REPRESENTATIVE FOOD STAMP HEARING CONTROL LOG AND INSTRUCTIONS
FORMS MANUAL REVISION #3 :IM-89, AGENCY REPRESENTATIVE FOOD STAMP HEARING CONTROL LOG AND INSTRUCTIONS
DISCUSSION:
Form IM-89, Agency Representative Food Stamp Hearing Control Log 
and instructions are revised. The changes are as follows:
- Field 2 - Type of Assistance - requires no entry. Complete the IM-89 for all food stamp cases EXCEPT disqualifications, withdrawals or individuals who do not appear for the hearing, and claims. Do not complete the IM-89 for IM cases.
- Field 3B - Supercase Number - is added.
- Field 7B - Action - only requires an “X” in the appropriate block; and
- The retention for the county office copy is three years. This is consistent with the retention of food stamp forms.
The remaining changes were to update the Agency name to Family Support Division, update the form to coincide with FAMIS, and to change the title of caseworker to Eligibility Specialist.
Complete the IM-89 within 10 days of receipt of the Decision and Order in the county office. Retain a county office copy.
To access the IM-89 and instructions on the Intranet, go to the Family Support Division Intranet home page and follow these steps:
- Click Food Stamps;
- Click Forms;
- Click Forms Manual;
- Click Volume 2;
- Scroll down to IM-89 Agency Representative Hearing Control Log; and
- Click on either the form or the instructions.
To E-mail the IM-89 to Program and Policy (Food Stamps), follow the steps listed below.
- Obtain the form from the IM Forms Manual on the Intranet.
- Complete the form and save it as a Word document.
- Insert the form in an E-mail and send it to Janice.Kapple@dss.mail.gov.
To fax the IM-89 to Program and Policy, send it to Bj Kapple at (573) 522-4333.
To mail the IM-89 to Program and Policy, send it through regular State Office mail to Bj Kapple at Program & Policy (Food Stamps) at P O Box 2320, Jefferson City, MO 65102.
Once the supply of this form is depleted in the warehouse, this form will be available online only.
NECESSARY ACTION:
- Review this memorandum with all appropriate staff.