Appendix F Forms Table of Contents | SNAP

VRA-95

Voter Registration Application Form

GA Secretary of State sos.ga.gov

1

OSAH Form 1 Food Stamps

10/23

osah.ga.gov

47

SNAP in Georgia

10/24

PAMMS

Arabic, Bosnian, Burmese, Chinese, Farsi, French, Gujarati, Hindi, Japanese, Korean, Nepali, Portuguese, Russian, Spanish, Vietnamese

74

Food Stamp Manual Budget Sheet

07/21

PAMMS

104

Statement of Child Care Expense

04/05

PAMMS

126

Self-Employment Work Calendar

06/16

PAMMS

Spanish

127

Calendar Log

11/07

PAMMS

Spanish

139

Contribution Statement

06/16

PAMMS

Spanish

173

Verification Checklist

06/10

PAMMS

Arabic, Bosnian, Burmese, Chinese, Farsi, French, Gujarati, Hindi, Japanese, Korean, Nepali, Portuguese, Russian, Spanish, Vietnamese

173

Appointment Letter

06/16

PAMMS

Spanish

240

Transitional Food Stamps Fact Sheet Instructions

12/14

PAMMS

296

Expedited SNAP Screening Guide

10/24

SO

Spanish

297

10/24

SO

Arabic, Bosnian, Burmese, Chinese, Farsi, French, Gujarati, Hindi, Japanese, Korean, Nepali, Portuguese, Russian, Spanish, Vietnamese

297A

Rights and Responsibilities

10/24

SO

Arabic, Bosnian, Burmese, Chinese, Farsi, French, Gujarati, Hindi, Japanese, Korean, Nepali, Portuguese, Russian, Spanish, Vietnamese

298

Senior SNAP Application

10/24

PAMMS

Spanish

299

Senior SNAP Project Brochure

11/23

PAMMS

Spanish

332

SNAP Works Mandatory Program Non-Compliance Good Cause Notice

01/14

SO

Spanish

333

Food Stamp Program Sanction/Penalty Notice Form

01/19

PAMMS

Spanish

334

SNAP Works Voluntary Program Non-Compliance Good Cause Notice

06/16

SO

Spanish

335

SNAP Works Program Notice of Completion Form

06/16

SO

Spanish

339

Simplified Reporting Requirement (SRR) Form

10/24

PAMMS

Arabic, Bosnian, Burmese, Chinese, Farsi, French, Gujarati, Hindi, Japanese, Korean, Nepali, Portuguese, Russian, Spanish, Vietnamese

354

Expense/Resource and Income Statement

01/08

SO

Spanish

406

SNAP Works Program Voluntary Invitation Notice

04/17

SO

Spanish

480

SNAP Works Participation Checklist

01/16

SO

Spanish

481

SNAP Works Check Request

01/17

SO

482

Work Experience Agreement

02/03

SO

Spanish

483

Employment Services Progress Review Notice

01/19

SO

Spanish

492

Employment Services Communication

01/14

SO

Spanish

493

SNAP Works Program Employability Assessment

01/16

SO

Spanish

494

SNAP Works Mandatory Appointment Notice

01/17

SO

Spanish

495

Job Search Record

08/22

SO

Spanish

498

Request for Reduction in Case Accuracy Reviews Instructions

06/07

SO

507

ABAWD Tracking Calendar

12/20

SO

Spanish

508

SNAP/Medicaid/TANF Renewal

For voter registration information, refer to the * at the top of the table or click [voter-registration]

10/24

SO

Arabic, Bosnian, Burmese, Chinese, Farsi, French, Gujarati, Hindi, Japanese, Korean, Nepali, Portuguese, Russian, Spanish, Vietnamese

513

SNAP Works Voluntary Program Personal Work Plan

01/19

SO

Spanish

514

SNAP Works Personal Work Plan Update

01/14

SO

Spanish

515

SNAP Works Mandatory Personal Work Plan

12/13

SO

Spanish

516

Job Search Record

10/22

SO

Spanish

517

Record of School Attendance and Performance Report

01/14

SO

Spanish

524

TANF Community Outreach Services (TCOS) Brochure

11/15

SO

Spanish

528

Supplemental Nutrition Assistance Program (SNAP) Periodic Report

10/24

SO

Spanish

713

Interagency/Interoffice Referral and Follow-Up

02/05

SO

713G

Grandparents Raising Grandchildren (GRG)

04/12

PAMMS

713-SW

SNAP Works Interagency/Interoffice Referral and Follow-Up

01/16

SO

Spanish

799

DFCS Communication

01/07

PAMMS

805

ABAWD Volunteer Work Verification

01/19

PAMMS

Spanish

806

Medical Statement

06/16

PAMMS

Spanish

809

Verification of Earned Income

06/16

PAMMS

Spanish

820

Third Party Verification of Citizenship

08/06

PAMMS

821

Statement of Shelter Costs

04/07

PAMMS

Spanish

823

ABAWD Work Requirements Fact Sheet

09/20

SO

Spanish

826

Ineligible ABAWD Time-Limit Adverse Action Notice

10/24

PAMMS

Spanish

826A

Ineligible ABAWD Time-Limit Second Three Month Adverse Action Notice

10/24

PAMMS

Spanish

829

SNAP Works Program Brochure

01/16

SO

Spanish

830

Food Stamp Work Requirements Fact Sheet

07/21

SO

Spanish

840

Medical Transportation Expense Log Instructions

03/09

PAMMS

841

Food Loss Replacement

04/20

PAMMS

846

Change Report Form

For voter registration information, refer to the * at the top of the table or click [voter-registration]

10/24

PAMMS

Arabic, Bosnian, Burmese, Chinese, Farsi, French, Gujarati, Hindi, Japanese, Korean, Nepali, Portuguese, Russian, Spanish, Vietnamese

858

Comparable Workfare Guide

05/22

PAMMS

Spanish

859

SNAP Consolidated Work Requirements Notice

10/24

SO

Spanish

864

SNAP Works Screening and Referral Tool

10/24

PAMMS

875

Verification of Educational Assistance Income

06/23

PAMMS

Spanish

880

Applying for Food Stamps Required Verification

10/23

PAMMS

5459

Authorization for Release of Information

07/16

SO

Spanish

5460

Notice of Privacy Practices

12/23

PAMMS

Spanish

5667

Request for Investigation

10/18

PAMMS

EBT 2

EBT Control Log-County Office EBT Cards

04/04

PAMMS

EBT 3

EBT Control Log-County Office PINS

04/04

PAMMS

EBT 4

EBT Control Log-Receipt of Card/PIN Benefit Representative

04/04

PAMMS

EBT 5

EBT Transfer Control Log- EBT Card Sign In/Sign Out Benefits Representative/Guardian

04/04

PAMMS

EBT 6

EBT Control Log-PIN Sign In/Sign Out Benefit Representative/Guardian

04/04

PAMMS

EBT 7

EBT Card/PIN Sign Out Authorization

04/04

PAMMS

EBT 8

EBT Family Service Worker/Recipient

04/04

PAMMS

EBT 9

Request for Manual Issuance of Benefits

04/04

PAMMS

EBT 10

Request for Re-Obligations of Benefits

04/04

PAMMS

G-845

INS SAVE Document Verification Request

USCIS website: www.uscis.gov