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COMBINED MANUAL

ISSUE DATE 01/2021

NOTICE OF INCOMPLETE OR MISSING REPORT FORM

0026.42

MAXIS will send a notice of termination at least 10 days before the effective date to clients who fail to submit a required Household Report Form (HRF) (DHS-2120) (PDF) or Combined Six-Month Report (CSR) (DHS-5576) (PDF).

The notice will contain the information in 0026.03 (Content of Notices) and the information listed below for each program.

For incomplete forms, send the Notice of Late or Incomplete Household Report Form, Health Care Renewal Form or Combined Six-Month Report or Recertification (DHS-2414) (PDF) using the time frames in 0007.12.06 (Incomplete HRF/CSR). Include the following information:

● When the HRF or CSR was received.

● The date the completed HRF or CSR was due.

● Which items were missing.

● That they must complete the missing items and return the form.

● The date by which they must return the HRF or CSR.

● What items of verification they must provide.

● If clients sign or send in a HRF before the end of the month for which they were reporting, tell them to sign and date the form again on or after the last day of the report month.

See 0007 (Reporting).

MFIP, GRH: Follow general provisions.

DWP: No provisions. See 0007.15 (Unscheduled Reporting of Changes - Cash).

SNAP: UNCLE HARRY FOOD SUPPORT CASES

The notice will inform clients they will receive benefits retroactive to the 1st day of the month the agency receives the completed HRF or CSR if they submit it in the month following the month in which it was due. They must meet all other eligibility requirements.

SNAP SIX-MONTH REPORTERS

The autoclose notice for Six-Month Reporters will contain a reminder sentence to inform clients that, if the Six-Month Report form is not returned to the county/tribal agency, their SNAP case will close within 10 days from the date of the autoclose notice.

The notice will inform clients they will receive benefits retroactive to the date the agency receives the complete CSR and the necessary verification(s) if they submit it in the month following the month in which it was due. They must meet all other eligibility requirements.

MSA: The notice will inform clients they will receive benefits retroactive to the 1st day of the month the agency receives the completed HRF or CSR if they submit it in the month following the month in which it was due. They must meet all other eligibility