Page 93
FOOD STAMP HANDBOOK
_FORMS AND INSTRUCTIONS
63-1230 STATE FORMS & INSTRUCTIONS (Continued)
63-1230
DFA 377.5 (12/83)
Manual information Question Section Requested EW Action 3A 63-501.51 Resource If anyone in the household got a licensed 63-505.514 Changes vehicle, this section is completed. The CWD must determine if the vehicle is resource exempt, and, if not, determine its countable value, 3B 63-501.4 If the household's liquid resources reach or ex- 63-501.2 ceed $1,500, this section is completed. 63-5013 63-5014 63-5017 63-501.8 63-503.44 63-505.515 63-409.21 For Yes answers to either 3A or 3B, complete 63-409.22 the resource eligibility test section of the budget worksheet. 4 63-102()) Medical if there is a change of $25 in the household's 63-300.517 Expenses medical costs for a household member who is 63-502.33 elderly or disabled this section is completed. 63-503.25 63-505.5114 63-505.53 For Yes answers, be sure that all information is provided, The household must attach bills for any expenses it lists. To be permitted as a deduction, increases in medical expenses must be reported in the month of billing or when the bill becomes due. 5A 63-505.513 Address/Phone if the househoild’s mailing address or phone
Number Change
number changed (whether or not the house- hold moved), this section and Section 5C are completed.
Issued 2/15/84
(PRA ARELIAL