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63-1230 STATE FORMS & INSTRUCTIONS (Continued)

Expedited Service Eligibility Review

63-1230 DFA 285-A1 (11/83)

Review Applicant's Step Question Answer

CWD Action

j 1 More than $100

Refer for norma! processing

1 $100 or less Go to Step 2 2 2 and 3 Income exceeds income Refer for normal processing Standard for household size 2and3 income does not exceed Go to Step 3 income standard for household size 3 3 No Refer for expedited service and and 4 No or Don’t Know 3 and 4 Any combination of Yes,Noor Refer for expedited service Don’t Know and amounts totaling less than $150 * Band 4 Any combination of Yes, No or Go to Step 4 Don't Know and amounts totaling $150 or more 4 5 No Refer for normal processing 5 Yes Go to Step 5 5 6 Yes Refer for expedited processing 6 No Go to Step 6