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BAM 401E 26 of 34 ELECTRONIC BENEFIT TRANSFER ISSUANCE SYSTEM BPB 2026-019 8-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

Complete the DHS 3955-A-EBT, Bridge Card Issuance Log Attachment. • Enter the entire number from the card on EBT Card Number line. • Enter Case Name (HOH) from the Bridges Case- Search/Summary on Client Name line. • Enter HOH's individual number from the Individual # field on the Bridges Case-Search/Summary on Recipient ID/Case Number line. • On Authorized Rep line, If the card is being issued to the FSAR, enter the name from Alternate Payee/Authorized Representative - Summary screen. • Record identification type and number on Type of ID Presented and ID Number lines, Respectively, on the DHS 3955-A-EBT, Bridge Card Issuance Log Attachment. In the absence of a valid photo identification, the specialist or supervisor confirms collateral contact ID by signing and dating the DHS-3955-A-EBT, Bridge Card Issuance Log Attachment on Type of ID Presented line. 6. Link card to HOH's Recipient Identification number using the ebtEDGE Administrative Terminal. • Print a copy of the screen "Card was successfully replaced" to retain as an attachment to the DHS-3955-A- EBT, Bridge Card Issuance Log Attachment. 7. Request HOH/Protective Payee/FSAR to sign on Client or Authorized Representative Signature line and enter date on the Date line of the DHS-355-A-EBT, Bridge Card Issuance Log Attachment. 8. Release the new card to HOH/Protective Payee/FSAR and request recipient/FSAR sign and print their name on the back of the card. Note: Replacement cards for the HOH are not to be given to the FSAR by local office staff. The FSAR should only receive their own card.