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ESA SNAP Policy Manual 192  Specify the verification the household must submit with the form.  Inform the household where to call for help in completing the form.  Include a statement to be signed by the member of the household or their authorized representative indicating their understanding that the information provided on the form may result in reduction or termination of benefits.  Include a brief description of SNAP fraud penalties.  If the form requests an SSN, the form (or attachment to the form) must include a statement that indicates an SSN is required to receive SNAP benefits, the legal authority to request SSNs (i.e. The Food and Nutrition Act of 2008, as amended, 7 USC § 2025(e) and Social Security Numbers, 7 CFR § 273.6), that nonhousehold members need not provide an SSN or information about their citizenship or immigration status, how the SSN will be used by ESA and the effect of not providing an SSN. ESA can use a combined mid-certification form for SNAP and TANF or Medicaid. If a combined form is used that includes SNAP, the form must clearly indicate that SNAP-only households do not need to provide information required by another program. The form must also advise that nonhousehold members do not need to provide their SSNs or information about citizenship or immigration status. Note: ESA has chosen the option to process changes affecting SNAP household deductions that are reported during the certification period, including at mid-certification, pursuant to 7 CFR § 273.12(c)(4). If ESA changes this option for certain deductions, the mid-certification form must include a statement explaining that some deductions will not change until the household’s next recertification and identify the deductions ESA will not change. 15.4.2 Mid-Certification Processing ESA must select a due date for SNAP households to return their mid-certification report form and verification to allow for sufficient time to process reports so that households will receive adequate notice of action on the report in the first month of the new reporting period. ESA must provide the household a reasonable period after the end of the last month covered by the report in which to return the report.  ESA mails the mid-certification report form at the end of the fourth month of the certification period and requests the household to return the completed form with verification by the first day of the sixth month of the certification period. Once the household returns the form, ESA must process the form and follow verification requirements in Section 5.14, Verification Required at Mid-Certification. For households that return the report and required verification by the specified due date, and the changes result in a reduction or termination of benefits, ESA must:  Send an adequate notice of action so that the household receives the notice no later than its normal issuance date in the seventh month. For households that fail to return the report by the specified due date: Return