SUBJECT:
FORM IM-39A, REQUEST FOR PUBLIC ASSISTANCE INFORMATION - OUTSIDE THE STATE OF MISSOURI AND INSTRUCTIONS
FORMS MANUAL REVISION #14: IM-39A, REQUEST
FOR PUBLIC ASSISTANCE INFORMATION - OUTSIDE
THE STATE OF MISSOURI
DISCUSSION:
Form, IM-39A, Request for Public Assistance Information - Outside the State of Missouri, with instructions, has been created. Use the IM-39A to inquire about an applicant's or recipient's receipt of public assistance benefits from another state. The form may be used at application, reinvestigation, or when information is received indicating that an individual receives public assistance benefits from another state.
Use of the IM-39A is appropriate if the claimant or an assistance group member:
- reports receiving public assistance in another state;
- has a history of receiving public assistance from another state;
- recently moved to Missouri from another state and there is reason to believe s/he may be receiving public assistance in that state; or
- lives in close proximity to another state and there is reason to believe s/he may be receiving public assistance in that state.
NOTE: Do not use the IM-39A to obtain food stamp information for food stamp applicants who screen as expedited eligible. Continue to contact the other state by telephone so that expedited service time frames can be met. FAMIS will not release any benefits, including expedited benefits, until verification is entered that the EU is not receiving food stamps in the current month.
The IM-39A form and instructions can be found on the Family Support Division Intranet in the Forms Manual, Volume 1. Scroll down to the
IM-39A and either select the form 
or instructions. The word version will be available soon.
NECESSARY ACTION:
- Review this memorandum with all appropriate staff.
- Begin using Form IM-39A immediately.