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VIRGINIA DEPARTMENT OF SOCIAL SERVICES TABLE OF CONTENTS
10/25 VOLUME V, PART XXIV, PAGE i
PART XXIV FORMS
FORM NUMBER NAME PAGES
032-03-1100-40-eng APPLICATION FOR BENEFITS 1-16
032-03-729A-20-eng RENEWAL APPLICATION FOR AG, SNAP, AND TANF 17-26
032-03-0823-11-eng EVALUATION OF ELIGIBILITY 27-31
032-03-823B-03-eng PARTIAL REVIEWS AND CHANGES 32-34
032-03-0819-14-eng SNAP - HOTLINE INFORMATION 35-37
032-03-0821-08-eng KNOW YOUR RIGHTS WHEN APPLYING FOR SNAP
BENEFITS 38-39
032-03-0718-08-eng EXPEDITED SERVICE CHECKLIST 40-41
032-03-0814-10-eng CHECKLIST OF NEEDED VERIFICATIONS 42-43
032-03-0117-21-eng NOTICE OF ACTION 44-47
032-03-0018-34-eng ADVANCE NOTICE OF PROPOSED ACTION 48-51
032-12-0157-21-eng NOTICE OF EXPIRATION 52-53a
032-03-0051-43-eng CHANGE REPORT 54-56
032-03-0153-15-eng ENTITLEMENT TO RESTORATION OF LOST BENEFITS 57-59
032-03-0148-03-eng REQUEST FOR CONTACT 60-61
032-03-0649-12-eng INTERIM REPORT FORM – REQUEST FOR ACTION 67-69
032-03-823A-05-eng PERMANENT VERIFICATION LOG 70-72
032-03-0388-05-eng FOOD REPLACEMENT REQUEST 73-74
032-03-0387-07-eng INTERNAL ACTION AND VAULT EBT CARD
AUTHORIZATION 75-77
032-02-0072-13-eng EMPLOYMENT SERVICES PROGRAMS
COMMUNICATION FORM 78-80
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