NORTH DAKOTA DEPARTMENT OF HUMAN SERVICES
Bismarck, North Dakota
November 14, 2003
IM 4936

TO:	Directors, County Social Service Boards
	Regional Representatives
	Quality Control Reviewers	

FROM:               Blaine L. Nordwall, Director, Economic Assistance Policy

SUBJECT:	Application for Assistance – SFN 405
	
PROGRAMS: 	Food Stamp Program

RETENTION:	Until Manualized

EFFECTIVE:	Upon Receipt

APPLICATION FOR ASSISTANCE – MANUAL CHAPTER 430-04-05 and On-Line 
430-05-20-15 

Part 2 of the Application for Assistance (pages 5-6) must be used to screen all households for expedited services. This IM supersedes only references to “the entire application” contained in IM 4934 dated October 9, 2003.

 Part 2 will be considered a completed application for food stamps if the household is entitled to expedited service and it contains the applicant’s name, address, household composition, income, assets, and the signature of the applicant, a responsible household member or authorized representative. If the shelter/utility cost questions are not completed, it is still considered a complete application and those expenses are not allowed when determining expedited benefits.  

If the household is entitled to expedite service, Part 2 must be registered as an application and the F017 FS Application Received – Interview Scheduled must be sent if the applicant is not interviewed at the time of request. The household must be afforded an opportunity to participate within the expedited timeframe.  This includes receiving the notice of eligibility within 7-days allowing two days mailing time, receiving F012 “EBT Client Training and Schedule Notice”, if applicable, allowing two days mailing time and allowing the household at least 24 hours within the 7-day timeframe to obtain an EBT card. 

If the household is not entitled to expedited service, Part 2 is considered an incomplete application if it contains the applicant’s name, address and the signature of the applicant, a responsible household member or authorized representative. This must be registered as a pending application and the interview and verifications cannot be postponed.  To complete the application process, Parts 3 through 6 of the application are required along with the interview and verifications.   The interview can be waived for hardship reasons.  The pending notice and F017 Food Stamp Application Received – Interview Scheduled, must be sent to the household. If the household fails to attend the scheduled interview, F018 Notice of Missed Interview must be sent.  If the household fails to contact the county, the application must be denied on the 30th day.

Until the current supply of the Application for Assistance is used (we currently have a five month supply), please print and replace page 6 of Part 2, with the attached pdf document.  This is the new page 6 and information has been added to assist in the screening process and preserve the filing date.  

If you have questions, please contact your Regional Representative.