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COMBINED MANUAL

ISSUE DATE 12/2014

WHEN TO USE AN ADDENDUM TO AN APPLICATION

0005.09.09

A Combined Application – Addendum (DHS-5223C) (PDF) must be completed and placed in the case record when a person is added to a cash assistance unit. Some programs require the client to complete the Addendum. For additional information, see 0005.09.03 (When People Must Complete an Application), 0005.09.06 (When Not to Require Completion of an Application), 0008.03 (Changes - Obtaining Information), 0008.06 (Implementing Changes - General Provisions), 0008.06.06 (Adding a Person to the Unit - Cash), 0008.06.07 (Adding a Person to the Unit - SNAP), 0008.06.12 (Adding a Person's Income).

MFIP, DWP: Require the client to complete an Addendum to add a person to the assistance unit. File it in the case record.

NOTE: Do NOT require a CAF Addendum from a client who formerly received SSI and was an ineligible member of an assistance unit. Update appropriate STAT panels and redetermine eligibility.

Disqualified and ineligible mandatory unit members do not need to complete an addendum since their income and assets are already being counted.

To determine when a Minnesota Transition Application Form (MTAF) may be used in place of a CAF Addendum, see 0008.06.06 (Adding a Person to the Unit - Cash).

SNAP: Do not require the client to complete an Addendum as a condition of eligibility, however, you may use the Addendum to gather information about the person being added. File it in the case record.

MSA, GRH: No provisions.

GA: Require the client to complete an Addendum to add a person to the assistance unit. File it in the case record.

Disqualified and ineligible mandatory unit members do not need to complete an addendum since their income and assets are already being counted.