Page 9

SNAP SNAP SNAP SNAP SNAP SNAP SNAP SNAP SNAP SNAP SNAP SNAP SNAP SNAP SNAP SNAP Required Forms SNAP TANF 2905 Application for Assistance, or NRD1 specific to the program being applied. X X 2321 EGB EBT Card Issuance Authorization X X 2043 Agreement of Cooperation N/A X 2179 Interface Consent N/A X (NNRC/Kinship only) 2136 Temporary Assistance for Needy Families Case Benefit Programs N/A X 2037 Assessment and PRP – Child Only Cases N/A X 2621 TANF Kinship Care N/A X (Kinship only) 2678 Domestic Violence Awareness N/A X 2906 Support Enforcement Information N/A X 225.2 Reported Changes / Recertification / Redetermination (TOC) Eligibility Factor SNAP TANF Nevada Residency Customer Statement Customer Statement Household Composition Questionable Verify Changes Separate Food Unit Questionable N/A Living Arrangement (TANF Minor Parents) N/A Verify TANF Assessment and PRP – Child Only Cases N/A Document Relationship Questionable Verify Changes Qualified Non-Citizen Status Verify & Document Verify & Document Social Security Number Discrepancy Discrepancy Critical Age Change Document Verify if Applicable New Disqualifications/Sanctions (includes non-cooperation with PRP and/or CSEP, ineligible students, SNAPET and voluntary quit, etc.) Document Document TANF Time Limits N/A Verify & Document TANF NEON TANF Loan ABAWD Time Limits Verify & Document N/A Earned and Unearned Income Verify Verify Self Employment (income & expenses) Verify Verity Income Disregard Status N/A Review & Update if applicable Income Interfaces (ESD, Social Security, etc.) Interface Interface Stepparent Status N/A Document if Questionable Disability/Incapacity Verify Verify only for TANF NEON Incurred Expenses (dependent care, medical expenses, child support) Verify Verify Standard Utility Allowance Verify N/A Shelter Costs (rent, mortgage, taxes, insurance, etc.) Verify Verify Rent Subsidy VERIFICATION AND DOCUMENTATION Division of Social Services Eligibility and Payments Manual 10 July 26 MTL 12/26 Initial Application/Adding New Household Members A-225.1