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BAM 401E 30 of 34 ELECTRONIC BENEFIT TRANSFER ISSUANCE SYSTEM BPB 2026-019 8-1-2026

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

Reconciling DHS- 3955-EBT and DHS-3955-A-EBT 1. Pull DHS-3955-EBT, Bridge Card Issuance Log, with attachments from secured file at least once a month. 2. Verify a DHS-3955-A-EBT, Bridge Card Issuance Log Attachment, is attached for each line on the DHS-3955-EBT, Bridge Card Issuance Log. 3. Review each DHS-3955-A-EBT, Bridge Card Issuance Log Attachment for completeness and accuracy. • Entire EBT Card Number line must be completed. • Client Name line must be completed. • Recipient ID/Case Number line must be completed. • Authorized Rep line must be completed, if applicable • Client or Authorized Representative Signature and Date line must be completed. • Issued by Signature and Date line must be completed. • Type of ID Presented line must be completed if picked up. • ID number line must be completed if picked up. The Following items are attached to the DHS-3955-EBT, Bridge Card Issuance Log: • Bridges Case Search/Summary screen print. • The "card was successfully replaced" screen print from the ebtEDGE Administrative Terminal. • DHS-3955-A-EBT, Bridge Card Issuance Log Attachment. 4. Generate the EBTMS210-1 MONTHLY CARD STATUS REPORT-COUNTY in EBT Edge to verify the number of cards issued on the DHS-3955-EBT, Bridge Card Issuance Log. Note: Print only the pages for your specific county using the PDF version.