MEMORANDUM

DISCUSSION:

Effective immediately, Form FS-1, Application for Food Stamp Benefits is revised. The form is revised to ensure the information received is an accurate reflection of the EU's circumstances. The revised form is four pages long and gathers enough information to determine expedited eligibility. The form corresponds with the Food Stamp online web application. The following new information is requested:

• Out of State Participation;
• Foster Care;
• Disability;
• Higher Education;
• Liquid Resources;
• Other Resources;
• Earned Income;
• Employment Changes;
• Self Employment;
• Expenses of Self Employment;
• Other Income;
• Medical Expenses;
• Shelter Expenses;
• Dependent Care Expenses; and
• Court Ordered Expenses.

The form also provides the following information to the EU:

• Reporting and verification of expenses;
• Voluntary disclosure of race and ethnicity;
• Voluntary disclosure and use of Social Security Numbers;
• Voluntary disclosure and use of citizenship and immigration status;
• Expedited service criteria;
• Non-discrimination and fair hearing rights;
• Notification and acknowledgement of fraud provisions; and
• Use of Child Support Enforcement data.

The IM-31C, Instructions For Making Your Food Stamp Application, IM-31B, Your Rights As A Food Stamp Applicant/Participant, and IM-31F, Instructions For Making Your Food Stamp Application and Food Stamp Rights are revised. When an EU requests an application be mailed to them, send the revised IM-31C, IM-31B, or IM-31F with the application, as appropriate.

An interview is required for all Food Stamp applications. See Section 1120.045.00 INTERVIEWS. The interactive interview is the basic tool for obtaining information to establish eligibility. The interview is also an instrument to provide information to the applicant about the program and his/her rights and responsibilities. Use the interview to explain each eligibility factor and the verification required, and discussing fully any point on which the applicant indicates concern. 

When an application is dropped off, or received by mail or fax, or a web application is received, always try to contact the EU by phone on the same day to conduct the interview. Enter a comment on attempted contacts on the comment screen attached to the Eligibility Unit Member Role (EUMEMROL, FM3Z) screen.

When a an application is received and contains enough information to assign a supercase number and DCN, and the applicant is not available for an in-person or telephone interview, flow to the Food Stamp Interview (FM1B) screen in FAMIS to schedule an interview.

If an expedited determination can be made and identity is verified, complete the determination, and postpone for the interview.

The FS-1PDF and WORD versions are available in the online IM Forms Manual on the FSD Intranet. Printed forms are available from the warehouse.

Destroy/recycle all versions of the FS-1 with a revision date prior to December 2011. The Spanish translation of the new version of the FS-1 will be available soon.

NECESSARY ACTION:

• Review this memorandum with appropriate staff

JM