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1072 Chapter 7:Worker guides • Section 2: SNAP worker guides (07/2026) Examples of Case Notes An Effective Case Note Situation: Oregonian stated on an application their income, but they estimated the amount. Case Note: Oregonian indicated they make $1000 per month but based on wage stubs and attestation from the Oregonian during the interview they make $1200 per month Situation: Application only had one person but there are 3 others that live there Case Note: Application states there is only one person, based on information gathered in the interview Oregonian did not include their children on the application. They were added to the case. Situation: Received information from an outside entity (aka: Child Welfare or Community Partner) Case Note: Received an email from Community Partner that there was an income change on the case. Acted on the information provided after verifying the source. Forms used in the SNAP program Following are the forms and their uses, as related to the Supplemental Nutrition Assistance (SNAP) program. The forms with the most high-volume use are grouped by type (for example, applications). The remainder of forms are listed in numerical order. With the implementation of ONE, most customer notices are sent directly from the ONE system automatically, with no required action from the worker other than to enter the customer’s information correctly. ONE is intuitive, and uses the information entered during data collection to determine what actions to take and which correspondence will be generated. Applications Form # Title/Use Paper Forms server PDF fill in DHS 415F Application for Services. Used at initial application and at recertification at self-sufficiency branches for individuals receiving SNAP, cash and/or medical benefits. For initial applications, this form is used with the DHS 6609 packet. X X X DHS 415X Additional space for other people living with you Used to supplement DHS 415F for large households applying for benefits. X X DHS 415Y Re-Application for Food Stamp Benefits (Part 1) Used at recertification at self-sufficiency branches to establish a filing date when the individual picks up the DHS 6608 recertification packet. X X