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VIRGINIA DEPARTMENT OF SOCIAL SERVICES PARTIAL REVIEWS AND CHANGES
10/24 VOLUME V, PART XXIV, PAGE 34
PARTIAL REVIEWS AND CHANGES
FORM NUMBER - 032-03-823B
PURPOSE AND USE OF FORM – May be completed by the eligibility worker to document changed information and partial eligibility evaluations.
NUMBER OF COPIES - One.
DISPOSITION OF FORM - The form is to be kept in the eligibility case record.
INSTRUCTIONS FOR PREPARATION OF FORM - Complete the identifying information for the case at the top of the form.
The BPS may complete the form to record changed elements and to document the impact of the change(s) on the household's eligibility.
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