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VIRGINIA DEPARTMENT OF SOCIAL SERVICES D-SNAP

10/24 VOLUME V, PART XX, APPENDIX I PAGE 20

Vault EBT Card Issuance Log

Form Number - 032-03-0391

Purpose of Form - This log provides a monthly listing of the over-the-counter vault cards the local agency issued for the Disaster Program. The log compiles information from the internal action forms and will support inventory control and requisitioning.

Use of Form - The Issuance Unit must prepare the issuance log upon receipt of the Internal Action and Vault EBT Card Authorization form from the Eligibility Unit and after the Issuance Worker links the vault card in the EBT System.

Number of Copies - One.

Disposition of Form - The Issuance Worker must retain the log for the current month with copies of the Internal Action and Vault EBT Card Authorization forms received in the month.

Instructions For Preparation of Form - The Issuance Worker must complete the log based on information from the internal action form. The Issuance Worker must also initial the log.

TRANSMITTAL #35