131.611 Verification of Good Cause Based on Domestic Violence

The CAO and applicant or recipient must fill out the Domestic Violence Verification F orm PA 1747 available on Docu S hare for all good cause claims based on domestic violence in these circumstances:

To accompany the above acceptable verification given by an applicant or recipient (Block 2)

To grant good cause on the applicant/recipient’s written consent based on proof of the good cause claim given by a third party on the form (Block 3)

To grant good cause for up to six months when an applicant or recipient says he or she is at risk of domestic violence and cannot get other proof of domestic violence safely within the established time frame (Block 4).

NOTE : The CAO may not contact the putative father or non-custodial parent to verify good cause based on a claim of domestic violence .