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_ FOOD STAMP HANDBOOK §3-1230 (Cont) FORMS AND INSTRUCTIONS Handbook

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

DFA 377.4 (12/83)

(instructions Revised 4/6/84} Change in Benefits

Check the Change box when food stamp benefits are increased or will be decreased, Enter the

effective date of the change, the current allotment, the amount of the new allotment, and the reason(s) for the change.

Hf the household is repaying a claim through allotment reduction (intentional program violation or inadvertent household error) the amount entered should reflect the actual allotment the household will receive. The explanation for the change should include the reasons for the change in benefits as well as the effect on the amount of allotment reduction.

Suspension

Check the Suspension box when information reported by a monthly reporting household om the CA 7 results in ineligibility for a one-month period. Enter the effective date of the suspension, the reason(s) and the month for which no benefits will be issued,

For all suspensions, enter the following statement in the Comments section:

“if the CA 7 you submit for the month of suspension shows that you are still not eligible for food stamps, your benefits will be terminated effective (enter appropriate date).”

Termination

Check the Termination box when food stamp benefits will be terminated. Enter the effective date of the termination and the reason(s).

Check the second box if the household’s benefits are terminated because resources have been transferred or because a one-person household failed to provide a Social Security Number within the appropriate time. Enter the date which is the end of the disqualification period. (For an SSN disqualification, the individual is disqualified until an SSN is provided.)

NOTE: Do not use the DFA 377.4 for disqualifications resulting from an intentional program

violation or refusal to work register. The DFA 377.7A and the DEA 377.10, respectively, are provided for these types of disqualifications.

Proposed Change in Benefits

Check the Proposed Change box when a monthly reporting household submitted a complete CA 7 which is missing verification/information of a deduction and/or contains questionable information.

Enter the proposed effective date of the change and the verification and/or information which the household must provide. .

Benefits may not be reduced, suspended or terminated based on this reminder notice. A timely notice of adverse action must be provided to the household before the adverse action is taken. (See the special instructions in the All-County Letter transmitting this material.}

CALIFORNIA-DSS-MANUAL-SS

Issue 2215 Effective 2/15/84

(MANUAL LETTER NO. 84-13) [)%%