213 REQUIRED VERIFICATION (FSM)

SR 14-15 Dated 12/14

Previous Policy

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The individual must provide verification of factors affecting household composition if questionable.

Assist the individual in obtaining verification if the individual is incapable of providing it because of a mental or physical disability.

Questionable Factor

Acceptable Verification

Household size

       A signed statement by an individual residing outside of the household who knows the individuals in the household.

-       The statement must include a listing of the individuals in the household and their address.

Marital Status

       Original or certified copies of legal documents such as marriage licenses or divorce decrees.

       Signed statements from relatives or individuals residing in the community.

       Other similar verification.

Purchasing and preparing food separately

       A statement signed by all adults residing within the household.

       A signed statement by an individual residing outside of the household who knows the individuals in the household.

       A completed BFA Form 768, Shared Shelter Arrangements.

       Other similar verification.

In a situation in which it is an adopted child > 18 and < 22 who is now living with his or her birthparents, a signed statement, under penalty of unsworn falsification, that he or she purchases food and prepares meals separately from his or her birthparent.

Disability

If not apparent, a physician’s statement that the disability prevents the individual from purchasing and preparing food.

Income less than 165% of net monthly limit

See Chapter 500 , Income.

References: He-W 701.03; He-W 742.02; He-W 756.05; RSA 161:4-a,IV; RSA 641:3; 7 CFR 273.1; 7 CFR 273.2