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COMBINED MANUAL
ISSUE DATE 01/2020
FORMS/HANDOUTS FOR APPLICANTS
0005.12.12.01
● Reporting Responsibilities for MFIP Households (DHS-2647) (PDF). See 0007.12 (Agency Responsibilities for Client Reporting).
● In cases where there is at least 1 non-custodial parent:
- Understanding Child Support - A Handbook for Parents (DHS-3393) (PDF).
- Referral to Support and Collections (DHS-3163B) (PDF). (This is in addition to the Combined Application Form or ApplyMN application, for EACH non-custodial parent). See 0012.21.03 (Support From Non-Custodial Parents).
- Cooperation with Child Support Enforcement (DHS-2338) (PDF). See 0012.21.06 (Child Support Good Cause Exemptions).
NOTE: This does not apply to a married parent who is out of the home on military duty when there is no breakdown in the marital relationship.
● Notice of Requirement to Attend MFIP Overview (DHS-2929) (PDF). See 0028.09 (ES Overview/SNAP E&T Orientation).
● If there is a custodial parent under 20, the Notice of Requirement to Attend School (DHS-2961) (PDF) and Graduate to Independence - MFIP Teen Parent Informational Brochure (DHS-2887) (PDF). If there is a custodial parent under age 18, the MFIP for Minor Caregivers (DHS-3238) (PDF) brochure. See 0012.06 (Requirements for Caregivers Under 20), 0028.06.03 (Who Must Participate in Empl. Services/SNAP E&T), 0028.12 (Education Requirements).
● Family Violence Referral (DHS-3323) (PDF) and Domestic Violence Information (DHS-3477) (PDF).
● If a non-parental caregiver applies, MFIP Child Only Assistance (DHS-5561) (PDF).
● For all applicants, How to Use Your Minnesota EBT Card (DHS-3315A) (PDF).
DWP: Follow MFIP, EXCEPT do not give the Notice of Requirement to Attend MFIP Overview (DHS-2929) (PDF) to the applicants. Instead, give the applicant the Minnesota’s Diversionary Work Program-DWP (DHS-4034) (PDF).
SNAP:
For all applicants:
● Supplemental Nutrition Assistance Program Reporting Responsibilities (DHS-2625) (PDF). See 0007.12 (Agency Responsibilities for Client Reporting).
● Facts on Voluntarily Quitting Your Job If You Are on the Supplemental Nutrition Assistance Program (SNAP) (DHS-2707) (PDF). See 0028.30.09 (Refusing or Terminating Employment).
● How to Use Your Minnesota EBT Card (DHS-3315A) (PDF).
● Work registration notice (DHS-7635) (PDF).
If there is student income, also give the Financial Aid Information Form (DHS-2646) (PDF). See 0010.18.30 (Verifying Student Income and Expenses).
MSA, GA, GRH:
● SSI Interim Assistance Authorization (DHS-1795) (PDF) and/or Interim Assistance Agreement (DHS-1795A) (PDF), if appropriate. See 0012.12 (Applying for Other Benefits), 0012.12.03 (Interim Assistance Agreements).