Page 4

FOOD STAMP HANDBOOK

63-1211 (Cont) —_ FORMS AND INSTRUCTIONS ee Handbook 63-1211 ACTIVE STATE FOOD STAMP FORMS (Continued) 63-1211 Form Form and Modification Currant Form Instruction Policy Form No, Titie Version Designation* Provided Provided DFA 289 Food Stamp Program — Receptionist’s Daily Tally Sheet 4-79 R-SP No No DFA 250 Food Coupon Book issuance Register 10-79 Rec. No No DFA 291 Summary of Daily Issuance Office Transactions . 5-74 + No No DFA 292 Coupon Book Inventory Record 8-79 R-SP No No DFA 293 Cashier's Daily Report 4-79 + No No DFA 283.1 Summary of Daily Reports 1-75 + No No DFA 299 Authorization to Participate Card 5-79 + No No DFA 300 Mail Issuance Log 1-80 % No , No DFA 301 Mail Issuance Request 3-80 + No No

. *Form Designation

R-NS — Required Form — No Substitutes

R-SP Required Form — Substitutes Permitted Rec. Recommended Form

+ Designation Pending

. CALIFORNIA-DSS-MANUAL-SS Rev. 1342 replaces Issue 2164 Effective 2/15/84

(MANUAL LETTER NO. 84-13) (4 |