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401.1 TANF MANUAL 7/24 Page 2

D. Who Completes the Application - If an individual is able to complete the application him or herself, the individual should do so. However, the local agency must assist individuals who have disabilities or language barriers and need assistance filling out the application. This help may consist of reading the application to the individual, explaining the meaning of the questions on the application, writing in the answers, or providing other forms of help. The local agency must inform all applicants verbally that this help is available when the DSS office provides the individual with the application or when providing access to CommonHelp from an agency computer, and must offer this assistance during the interview if there is an indication that the individual has had difficulty completing the application. If the individual needs help completing the application, this help must be provided. If help is needed, the interactive interview must include time to read each section of the application to the applicant, with sufficient explanation and rephrasing to make the meaning clear. During the interview, the EW will enter the information provided into the VaCMS system. Additionally, the following forms must be reviewed and completed with the applicant, and signed by the applicant, prior to case approval:

• Do You Have a Disability? (032-03-0670) – (exception*) • Notice of Personal Responsibility for the TANF Program (032-03-0750) • Notice of Cooperation and Good Cause (032-03-0036) • Notice of Intentional Program Violations and Penalties (032-03-0646)

*If the applicant fails to return the signed and dated, Do You Have a Disability? form (032-03- 0670), the EW must not deny the application. The case record must contain the Do You Have a Disability? form (032-03-0670) and be documented to show that the applicant was provided with oral and written information and was provided with a copy of the written information. If all other eligibility criteria are met, the application must be approved.

After the interview is completed, the information entered must be reviewed with the applicant. The EW must also read and explain to the applicant/spouse the statements pertaining to the applicant's responsibilities including the responsibility for providing accurate information and the penalties for withholding or providing false statements. The case record must contain the Rights and Responsibilities form (032-03-0440) or be otherwise documented to show that the applicant was provided with oral and written information about his rights and responsibilities and acknowledged receipt of the information.

If the application is made by an adult, including an authorized representative, or by a married minor parent living with a spouse, only the signature of the person making the application is required on the application and required forms. The signature of the spouse should be obtained if the spouse participates in the interview. However, the absence of the spouse's signature will not negate the validity of an application. For an application filed through CommonHelp, the application is considered signed when the applicant enters his name on the signature line.

If the application is made by a minor parent who is single, separated, or divorced and who is living with a parent or relative, or with an individual standing in loco parentis, the application must also be signed by the parent or relative or individual standing in loco parentis. If the minor parent does not live with a parent, relative or an individual standing in loco parentis, and the agency determines that the minor parent meets an exemption to the minor parent residency requirement at 201.5C, only the minor’s signature is required.

TANF Transmittal 78