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Nevada Division of Welfare and Supportive Services Energy Assistance Program Manual II. Completing the Administrative Disqualification/Penalty Waiver, Form 6021-AF

The Investigations and Recovery Unit will complete the Administrative Disqualification/Penalty Wavier, Form 6021-AF when necessary. III. Signed IPV Waiver

If a signed Administrative Disqualification Hearing/Penalty Waiver is obtained at the EAP office or a District Office, the worker must forward the waiver to hearingsI&R@dwss.nv.gov for IPV processing. IV. Unsigned IPV Waiver

If the accused individual provides an unsigned waiver at a District Office, the worker shall refer the client to call the “Preparer” listed on the waiver or email hearingsI&R@dwss.nv.gov. G. IPV Methods There are three methods by which an accused individual may be penalized. They are: I. Acknowledgment and voluntary acceptance of the penalty by the accused via a signed Form 6021-AF and a notification from I&R; II. By formal order of the Division of Welfare and Supportive Services Hearings Officer after conclusion of the administrative penalty/disqualification hearing process; or III. By conviction in a criminal court for any offense related to violation of Energy Assistance Program rules. It should be noted the applicant/recipient may elect to 1) sign/not sign Form 6021-AF, and/or 2) participate/not participate in the administrative penalty/disqualification hearing process. H. Coordination of IPV Actions To eliminate confusion and duplication of effort, all Administrative Disqualification/Penalty Waivers, Form 6021-AF, must be approved by the EAP Program Manager before being transmitted to the I&R Unit assigned responsibility for the submitting office. The signature and approval of the EAP Program Manager is mandatory to ensure prior penalty occurrences have been checked and worker actions are not duplicating the actions of I&R staff. When a 6021-AF is signed by the accused and approved by the designated EAP staff, it must be forwarded to the I&R Unit within two (2) business days. I. Imposing Intentional Program Violation (IPV) Penalties/Repayment Obligations

I. After approval, I&R staff will prepare and send a copy of the waiver and Notice of Imposition of Penalties to the accused individual and the EAP Program Manager advising of DWSS’s intent to impose disqualification penalties. MTL 01/24 June 25, 2024 - 6 - Section 1300 – Overpayments and IPVs