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VIRGINIA DEPARTMENT OF SOCIAL SERVICES SNAP E&T NOTICE OF CASE CLOSURE

10/24 VOLUME V, PART XXV, APPENDIX II, PAGE 36

SNAP E&T NOTICE OF CASE CLOSURE

FORM NUMBER - 032-02-0089

PURPOSE OF FORM -

This form informs households of the closure of the SNAP E&T case due to the failure to comply with SNAP E&T requirements. The form also establishes the time frame of five working days to establish good cause and notes the reason for being out of compliance.

USE OF FORM - The form must be sent to each participant after the participant fails to comply with SNAP E&T requirements.

NUMBER OF COPIES - Two

DISPOSITION OF COPIES - Original is sent to the participant Copy is maintained in participant’s case record

INSTRUCTIONS FOR PREPARATION OF FORM:

1. Complete the identifying case information and the name and address of the person who did not comply with SNAP E&T requirements.

2. Check the appropriate block indicating what the participant failed to do.

3. Enter the last day of the 5-working-day good cause time period in the two remaining blanks.

Example

The SNAP E&T Worker sent a SNAP E&T Notice of Case Closure to a participant who was out of compliance on Thursday, March 3rd. The date by which the participant must contact the worker no later than March 10th.

4. Include the SNAP E&T worker/case manager’s name and phone number.

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TRANSMITTAL #35