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1074 Chapter 7:Worker guides • Section 2: SNAP worker guides (07/2026) Form # Title/Use Paper Forms server PDF fill in DHS 6623 Individual TANF/Medical Packet – PA Used when an individual is renewing TANF or medical, along with SNAP benefits. X X DHS 7476 Employment Related Day Care (ERDC) and Supplemental Nutrition Assistance Program (SNAP) Application Used when an individual is renewing ERDC and/or SNAP benefits. X X X Pending forms Form # Title/Use Paper Forms server PDF fill in DHS 210A Notice of Information or Verification Needed Used in rare circumstances when a manual pend is necessary; to request information or verification on an open case. The notice notifies the individual of the information needed for their continued eligibility and the due date. X X X DHS 210ABW Notice of information or verification needed for an Able Bodied Adult Without Dependent Used to request hours or other information from an ABAWD needed to show the month is not a counting month. X X X Rights and responsibilities Form # Title/Use Paper Forms server PDF fill in DHS 222 Facility as Authorized Representative Used to notify A&D treatment centers and Group Care Homes of their responsibilities when they are the authorized representative. None X MSC 4214 Your Rights and Responsibilities Used at self-sufficiency branches with applications to explain individual rights, responsibilities, and reporting requirements. X X SNP- 0017A Consolidated Notice for SNAP Work Rules Used to notify SNAP individuals about the SNAP general work rules for work registrants and the SNAP time limit rules for Able Bodied Adults without dependents. This form also covers information for the STEP program. X X Individual report forms and related forms