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Division/Section Family Support Chapter No./Name 4 – Economic Stability (ES) Part No./Name C – Case Processing Section No./Name C-100-FITAP-SNAP Household Determination Document No./Name C-170-SNAP Authorized Representative Effective Date August 15, 2022

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If the designation is made by a household member who cannot sign his name, his mark must be witnessed by someone other than the authorized representative.

An authorized representative may be designated by completion of:

 the authorized representative section on the CAFÉ Self Service (SSP) application, simplified report or change report,

 the authorized representative item on form OFS 4APP, or OFS 4MR,

 the Supplemental Nutrition Assistance Program (SNAP) 4AR, or

 a written statement signed by the head of household, the spouse, or another responsible member of the household. The document must be scanned and indexed into OnBase.

Note: An individual who has a General Power of Attorney for the head of household may act as authorized representative without an additional written statement signed by the head of household.

Note: If the head of the household completes an application in CAFÉ SSP and names an authorized representative, this is considered designated in writing.

* Note: If the head of household or other responsible household member completes a no form application and a telephonic signature for their household, and names an authorized representative, the naming of the authorized representative is considered a written designation.

 Aware of the household circumstances. Except for drug/alcoholic treatment centers or group living facilities acting as authorized representative, the client is liable for any overissuance resulting from inaccurate information that the authorized representative gave.

The authorized representative applying for the household must sign the application.

If an AR applies for the household, the identities of both the authorized representative and the head of the household must be verified.

EXCEPTION: If it is necessary to meet expedited service time limits, you may verify identity only of the authorized representative being interviewed.

Note: If the AR completes a No Form interview and the telephonic signature on behalf of the household, written designation signed by the head of household, or another responsible household member is required. To request the written designation, send a Free Form Contact Letter and attach a SNAP 4AR to the request. **