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Handbook FORMS AND INSTRUCTIONS ___63-1230 (Cont.)

63-1230 STATE FORMS & INSTRUCTIONS (Continued) 63-1230

DFA 287 (4/80)

Form instructions {for CWD Worker}

FOOD STAMP PROGRAM IDENTIFICATION CARD

Purpose:

The DFA 287 is issued to each certified household as proof of program eligibility. {tt must be presented when the head of household, designated authorized representative, or any responsible household member redeems an Authorization to Participate card (ATP) or, if requested, when

food stamps are used to purchase consumable items, or in HIR counties, when the household obtains its coupons.

Preparation:

The CWD prepares one card at the time of initial certification and issues it in the name of the head of household.

NOTE: If the [D card is mailed to the household, it must not be mailed in the same envelope with the ATP or food coupons.

The following identifying information is entered on the card:

Head of Household

- Date

- Case Number

- Number of Persons in Household

Check applicable box indicating if the household is eligible for delivered meals.

The head of household, designated authorized representative or any responsible household member must then sign the ID card prior to using it. If the household does not name an authorized representative or other household member the CWD must indicate on the ID card that no designation was made. The household may also designate an emergency authorized representative at a later date. At that time, the emergency representative signs the ID card in the space provided.

The ID card may be serially numbered at the CWD’s option.

NOTE: if the household is eligible for and interested in delivered meal services, the CWD marks the face of the ID card with the jetter “‘M”. if the household is certified for delivered meals for a temporary period, the CWD indicates an expiration date on the 1D card. In counties where restaurants are authorized to accept food stamps, and if the househoid is eligible and interested in using communal dining facilities, the CWD marks the face of the [D card with the letters “CD”.

CALIFORNIA-DSS-MANUAL-SS Issue 2199