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SNAP CERTIFICATION MANUAL – APPENDIX A Arkansas Department of Human Services Division of County Operations DCO-207 - DCO-223 List of SNAP Forms Form Number Form Name Revision Date Use How to Access Form Form Fields DCO-207 SNAP Workers Referral/ Change Oct-02 Used to refer SNAP recipients to the Workfare Sponsor in counties where the Workfare Program is operating. Also used to transmit information that will affect Workfare participation. Maintained at Workfare County NA DCO-208 Notification of Workfare Obligation Jun-95 Used by the county office to notify Workfare Program participants of their Workfare obligation. Maintained at Workfare County NA DCO-209 Workfare Exchange of Information Oct-95 Used by the county office and the Workfare office to exchange information about workfare participants. Maintained at Workfare County NA DCO-210 Workfare Quarterly Report Jun-95 Used by the county office to provide a quarterly count of participants. Maintained at Workfare County Office Yes DCO-212 Workfare Monthly Activity Report Jun-95 Used by the Workfare Administrator or designee to report program activity to the county office. Maintained at Workfare Site NA DCO-215 Request for Assistance Sept-17 Multi-program application form DHS SHARE Spanish form on DHS SHARE Order from warehouse Yes DCO-218 Request for Information Semi- Annual Report Oct-03 Request needed information from households who submit a semi- annual report DHS SHARE Spanish form on DHS SHARE Order from warehouse Yes DCO-219 Notice of Appointment Feb-09 Used to schedule appointments for TEA, SNAP and Medicaid applicants. DHS SHARE Spanish form on DHS SHARE Order from warehouse Yes DCO-223 Application for Homeless Meal Provider Status Nov-08 Used by homeless shelters that wish to accept voluntary contributions of SNAP benefits in exchange for meals. DHS SHARE ONLY Spanish form on DHS SHARE No