1145.055.00 Investigation/Disqualification Forms – DSS Manuals

IM-140 November 30, 2005

The following forms are used in the investigation, tracking and referral for disqualification for intentional program violation:

FSD/WIU Investigation Tracking Sheet

Advance Notice of Your Administrative Disqualification Hearing (IM-160)

Waiver of Administrative Disqualification Hearing Consent Agreement (IM-161)

Withdrawal of Waiver of Administrative Disqualification Hearing Consent Agreement (IM-161A)

The use of these forms is described in the following sections:

1145.055.05 FSD/WIU Investigation Tracking Sheet

1145.055.10 Advance Notice of Your Administrative Disqualification Hearing (IM-160)

1145.055.15 Waiver of Administrative Disqualification Hearing Consent Agreement (IM-161)

1145.055.20 Withdrawal of Waiver of Administrative Disqualification Hearing Consent Agreement (IM-161A)