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Page | 43 308 Information Request There are different versions of this form that are used to request additional information from a household to make an eligibility determination when a change has been reported. 311 Interagency Notice of Certification A form sent to tribal entities after a household has been certified for SNAP; also used to determine whether or not a customer is certified for commodities. 312 Supervisory Review Form This form can be used if the Supervisory Database is not working, and a supervisory review needs to be completed on a specific case. 314 Medical Expense Sheet The form is used for the individual to list medical expenses, and an electronic form is used to calculate the allowable medical deduction to be used in the budget. Used for a person with a disability or individual age 60 and older who would like to claim a medical deduction. 319 Request for Hearing A form that can be used to make an oral request for a fair hearing by a customer or the form can be given to the customer to request a hearing if they are in the office. 320 Self-Employment Ledger A form given to a customer who reports being self- employed. This form is used to record the income and expenses of their self-employment business. Usually used if this is a new business and income taxes have not been filed yet or if no taxes are filed for the self-employment business. 324 Wage Verification Form This form is used to request verification of employment for a customer applying for benefits. 328 Student Eligibility Checklist A form used to determine whether or not an individual attending school meets student eligibility guidelines. 333 Notice of Missed Appointment Form used to inform applicant of missed interview appointment and requests applicant to make a contact to reschedule. 335 Voluntary Change to Case A form used to request a case be processed the month following an ineligible month. It is also used to voluntarily close a case. 336 Shelter/Eating Arrangement Form Lists a customer’s living arrangements including roommates, rent paid, utilities paid, and eating arrangement. 337 Rental Verification Form Form completed by the landlord. Confirms all rent, utilities, and other expenses of the applicant. 342 Self-Employment Questionnaire Used by EABS who calculate self-employment if customers choose to use actual expenses. 344E SNAP Disaster Replacement/Affidavit A form completed by a customer to request replacement of SNAP benefits after their food has been destroyed. There are specific criteria that have to be met in order for replacement benefits to be issued.