Page 579

VIRGINIA DEPARTMENT SNAP SANCTION NOTICE FOR OF SOCIAL SERVICES NONCOMPLIANCE WITH A WORK REQUIREMENT

10/24 VOLUME V, PART XXIV, PAGE 83

SNAP SANCTION NOTICE FOR NONCOMPLIANCE WITH A WORK REQUIREMENT

FORM NUMBER - 032-03-0174

PURPOSE OF FORM - To notify households or individuals of the reduction or termination of their SNAP benefits because of the disqualification penalty caused by quitting a job or reducing work without good cause.

USE OF FORM - The BPS must complete this form if an individual voluntarily quit a job or reduced work hours without good cause.

NUMBER OF COPIES - Two.

DISPOSITION OF FORM - The original must be sent to the household. The copy must be retained in the SNAP case record.

INSTRUCTIONS FOR PREPARATION OF THE FORM

The BPS must send this form for findings of voluntary quit or work reduction. The BPS must send the form even if the certification period is expiring or the household had previously been notified of adverse action for some other reason on another form.

Enter the appropriate identifying information at the top of the form.

Enter the name of the person who did not comply, and the requirement with which he/she did not comply.

Check the appropriate entry to indicate if the entire household or if only an individual is to be sanctioned. List the months of the sanction, the reduction in benefits and the effective date, as appropriate.

Enter the date by which an appeal may be requested in order to continue benefits at the original amount. Enter the day that is 11 days after the date of mailing.

Complete the information at the bottom of the form.

TRANSMITTAL #35