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FOOD STAMP HANDSOOK ~-~—~-....._FORMS_AND INSTRUCTIONS Handbook

63-1251 (Cont)

63-1251 FORM MODIFICATION POLICY — APPENDICES (Continued) 63-1251 .3) Appendix 3 — Form-Specific Modification Criteria (Continued)

(DFA 377.3 (9/80) Repealed by Manual Letter No. 84-13, 2/15/84)

DFA 377.4 (12/83) (Criteria revised 4/6/84)

Food Stamp Notice Of Change Required Form - No Substitutes Placement* - No modification permitted (Manuai only), - No modification permitted except those related to EDP requirements (EDP only).

Language* - No modification Permitted except that on the back, the address for submitting a

hearing request may be modified in counties with state hearing intake at the local level (Manual only).

- No modification permitted except (1) the wording in the Change, Suspension or Termination section may be modified to accommodate the inclusion of a budget com- putation, and (2) on the back, the address for submitting a hearing request may be modified in counties with state hearing intake at the focal level (EDP only}.

Data Elements - No modification permitted except that each section (Change, Suspension, Termination and Proposed Change) may be printed as its own form. (Manual only).

- No modification permitted except that all data elements need not appear on

one form; i.e., computer prints out only applicable message(s), but all messages are contained in the computer program (EDP only).

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* The additional explanations provided with All-County Letter 84-47 dated April 19, 1984 must be used without modification in accordance with the instructions contained in the letter.

CALIFORNIA-DSS-MANUAL-SS Issue 652k Issued 2/15/84