SNAP No Interview Demonstration
Notice packet
Project Dates
September 1, 2012 –
November 30, 2013
SNAP BENEFITS APPROVED IN SIMPLIFIED REPORTING
Your food benefits have been approved. You did not need to have an interview because your DHS office is participating in a special project. We approved your benefits based on the information you gave us and proof you provided.
Your food benefits start on ##/##/##. Your first month's food benefits will be $#,###.##. If there are no other changes, your full month's food benefits will be $#,###.##. Your food benefits are based on ## person(s) and $#,###.## countable income. Your benefit period will be ##/##/## to ##/##/##. If you need food benefits after that date, you will need to reapply.
We are placing you in the Simplified reporting system (SRS). This
means you only need to report one thing during a six-month period.
You must report when your monthly gross income is more than $#,###.##.
Report this change by the 10th of the month after the change. You do not need to
report other changes. However, you may want to if they will give you
more benefits. If you are receiving cash or medical benefits you
must continue to report the changes for those programs.
People in the Simplified Reporting System must fill out the Interim
Change Report form in six months.
This form will be mailed to you in the fifth month.
You may also qualify for other help. The Oregon Telephone Assistance
Program (OTAP) helps with the cost of basic phone service. Families with
children can get free or low price school meals. In some areas, meals
are offered in the summer
Talk to your worker for more about this.
If anyone in your group has an overpayment, your monthly food
benefits will be less until the amount is paid back. The reduction
will be $10.00 or 10%, whichever is more. We may also collect the
overpayment from tax returns.
Oregon Administrative Rules: 461-110-0530, 461-115-0040, 461-115-0450, 461-150-0060, 461-150-0070, 461-150-0080, 461-150-0090, 461-155-0190, 461-160-0060, 461-160-0070, 461-160-0430, 461-165-0060, 461-170-0010, 461-170-0011, 461-170-0101,
461-170-0102, 461-180-0080, and 461-195-0551
If you disagree with this action, you have the right to a hearing.
Please read Part 1 on the back of this form for more information.
Notice is generated when: Computer initiated when a case is opened or a redetermination is done in SRS – Non NED cases.
Notice is sent on: System initiated based on CRT or REC and SRS action.
SNAP Initial Month’s Benefits Approved in SRS (NED)
Your food benefits have been approved. You did not need to have an interview because your DHS office is participating in a special project. We approved your benefits based on the information you gave us and proof you provided.
Your food benefits start on XX/XX/XX. Your first month's food
will be $X,XXX.XX. If there are no other changes, your full month's food benefits will be $X,XXX.XX. Your food benefits are based on XX person(s) and $X,XXX.XX countable income. Your benefit period will be XX/XX/XX to XX/XX/XX. If you need food benefits after that date, you will need to reapply.
We are placing you in the Simplified Reporting System (SRS). This
means you only need to report one thing during a twelve month period.
You must report when your monthly gross income is more than $X,XXX.XX.
Report this change by the 10th of the month after the change. You do not
need to report other changes. However, you may want to if they will
give you more benefits.
You may also qualify for other help. The Oregon Telephone Assistance
Program (OTAP) helps with the cost of basic phone service. Families with children can get free or low price school meals. In some areas, meals are offered in the summer. Talk to your worker for more about this.
If anyone in your group has an overpayment, your monthly food benefits will be less until the amount is paid back. The reduction
will be $10.00 or 10%, whichever is more. We may also collect the
overpayment from tax returns.
Oregon Administrative Rules: 461-110-0530, 461-115-0040, 461-115-0450, 461-150-0060, 461-150-0070, 461-150-0080, 461-150-0090, , 461-155-0190, 461-160-0060, 461-160-0070, 461-160-0430, 461-465-0060, 461-170-0010, 461-170-0011, 461-170-0101, 461-180-0080 and 461-195-0551.
If you disagree with this action, you have the right to a hearing.
read Please Part 1 on the back of this form for more information.
Notice is generated when: Computer initiated when a case is opened or a redetermination is done in SRS – with NED household type.
Notice is sent on: System initiated based on CRT or REC and SRS action.
INITIAL MONTH'S SNAP BENEFITS APPROVED
Your food benefits have been approved. You did not need to have an interview because your DHS office is participating in a special project. We approved your benefits based on the information you gave us and proof you provided.
Your food benefits start on ##/##/##. Your first month's
benefits will be $#,###.##. If there are no other changes, your full
month's food benefits will be $#,###.##. Your food benefits are based on
## person(s) and $#,###.## countable income. Your benefit period will be
##/##/## to ##/##/##. If you need food benefits after that date, you will need to reapply.
You must report changes. The list of these changes is on the Rights and Responsibilities form.
Report all
changes within 10 days. You must report when the source of
your income changes. You must also report a change in earned
income of $100 or more a month, and a change in any other income
of $50 a month or more.
.
You may also qualify for other help. The Oregon Telephone Assistance
Program (OTAP) helps with the cost of basic phone service. Families with
children can get free or low price school meals. In some areas, meals
are offered in the summer.
Talk to your worker for more about this.
If anyone in your group has an overpayment, your monthly food benefits will be less until the amount is paid back. The reduction will be $10.00 or 10%, whichever is more. We may also collect the overpayment from tax returns.
Oregon Administrative Rules: 461-110-0530, 461-115-0040,
461-115-0450, 461-150-0060 - 0090, 461-155-0190, 461-160-0060,
461-160-0070, 461-160-0430, 461-165-0060, 461-170-0010, 461-170-0011,
461-180-0080, and 461-195-0551
If you disagree with this action, you have the right to a hearing.
Read Part 1 on the back of this form for more information.
Notice is generated when: Computer initiated when a case is opened or a redetermination is done for Change Reporting cases.
Notice is sent on: System Initiated based on CRT or REC action.
NOTM,FSP00OI
SNAP BENEFITS DENIED; OVER INCOME LIMIT
Based on the information you provided with your application for food benefits we are denying your application. We used XX persons and $X,XXX.XX countable income. You are over the income
limit. You have too much income to qualify.
You may request to speak with an eligibility worker about this decision. To talk with a worker about this decision please contact:
Worker Name: XXXXXXXXXXXXXXXXXXXXXX
Phone number: XXX XXX-XXXX ext. XXX
Oregon Administrative Rule: 461-155-0190
If you disagree with this action, you have the right to a hearing.
Read Part 1 on the back of this form for more information.
NOTM,FSP00FC
SNAP BENEFITS DENIED; DIDN'T PROVIDE VERIFICATION AFTER INTERVIEW
We are denying your application for food benefits. We asked you to give us certain information or proof. This information was needed to show you are eligible for food benefits. You needed to give us the information within 30 days of applying. You did not give us this information or proof. We are not able to make a decision if you can get food benefits without this information or proof.
You may request to speak with an eligibility worker about this decision. To talk with a worker about this decision please contact:
Worker Name: XXXXXXXXXXXXXXXXXXXXXX
Phone number: XXX XXX-XXXX ext. XXX
You may apply again at any time.
Oregon Administrative Rules: 461-115-0210, 461-115-0610, and
461-115-0651
If you disagree with this action, you have the right to a hearing.
Read Part 1 on the back of this form for more information.
Notice is generated when: Worker initiated and used when entering a denial with reason code of FC and System Initiated on the 31st or 60th day from filing date.
Notice is sent: Date worker initiated or System initiated on the 30th or 60th day if no action taken on case.
NOTM,FSP00FH
SNAP BENEFITS DENIED; FAILURE TO COOPERATE WITH OFSET
Your application for food benefits has been denied. You did not work with the OFSET program. You did not meet the work requirement and did not have good cause. You are disqualified and cannot get food benefits. The letter you got that told you about the disqualification also told you how long you will be disqualified.
If this is the first time you did not meet the work requirements, you cannot get food benefits for at least 1 month. If it is the second time, you cannot get food benefits for at least 3 months. If it is the third time or more, you cannot get food benefits for at least 6 months.
You may get food benefits after the minimum time period if you have worked with OFSET while you were disqualified. You will still be disqualified after the minimum period if you do nothing. To work with the OFSET program, talk to your worker to find out what you need to do.
You can reapply for food benefits any time.
You may request to speak with an eligibility worker about this decision. To talk with a worker about this decision please contact:
Worker Name: XXXXXXXXXXXXXXXXXXXXXX
Phone number: XXX XXX-XXXX ext. XXX
Oregon Administrative Rules: 461-130-0310, 461-130-0315, 461-130-0327, 461-130-0330,461-135-0520, 461-135-0521
If you disagree with this action, you have the right to a hearing.
Read Part 1 on the back of this form for more information.
NOTM,FSP00JQ
SNAP BENEFITS DENIED FOR A JOB QUIT
We are denying your application for food benefits. You quit a job in the
last 30 days before you applied. Or you reduced your work hours to
less than 30 hours a week. It was found that you did not have good
cause.
You cannot get food benefits due to this job quit. You are
disqualified for at least one month. If this is the second time, you
cannot get food benefits for at least three months. If this is the third
time, you cannot get food benefits for at least six months.
You can reapply for food benefits at the end of the disqualification.
You can reapply earlier if your situation changes so
you no longer have to meet the work requirement.
You may request to speak with an eligibility worker about this decision. To talk with a worker about this decision please contact:
Worker Name: XXXXXXXXXXXXXXXXXXXXXX
Phone number: XXX XXX-XXXX ext. XXX
Oregon Administrative Rules:, 461-130-0310, 461-130-0315, 461-130-0327, 461-130-0330, 461-135-0521
If you disagree with this action, you have the right to a hearing. You
also have the right to continued benefits. Read the back of this form
for more information.
NOTM,FSP00NC
SNAP BENEFITS DENIED; NOT A CITIZEN OR ELIGIBLE NON-CITIZEN
Based on the information you provided, we are denying your application for food benefits. To get food benefits, there must be at least one member who is a U.S. citizen or a
qualified non-citizen. No one in your household meets this requirement.
You may request to speak with an eligibility worker about this decision. To talk with a worker about this decision, please contact:
Worker Name: XXXXXXXXXXXXXXXXXXXXXX
Phone number: XXX XXX-XXXX ext. XXX
Oregon Administrative Rules: 461-120-0110 and 461-120-0125
If you disagree with this action, you have the right to a hearing.
Read Part 1 on the back of this form.
NOTM,FSP00NR
SNAP BENEFITS DENIED; NOT A RESIDENT
We are denying your application for food benefits. You are not
a resident of Oregon. You must be a resident of Oregon to get food
benefits.
You may request to speak with an eligibility worker about this decision. To talk with a worker about this decision please contact:
Worker Name: XXXXXXXXXXXXXXXXXXXXXX
Phone number: XXX XXX-XXXX ext. XXX
Oregon Administrative Rule: 461-120-0010
If you disagree with this action, you have the right to a hearing.
Read Part 1 on the back of this form
NOTM,FSP00ST
SNAP BENEFITS DENIED; INELIGIBLE STUDENT
Based on the information you provided with your application for food benefits, we are denying your application. You are in higher education at least half time and you do not meet any of the student criteria. You are not an eligible student. To be an eligible student you need to:
· Be physically or mentally unfit for employment
· Be a paid employee working an average of 20 hours each week
· Be self employed at least 20 hours each week and have countable monthly income of at least $1,247 after business costs
· Be awarded state or federally funded work-study and either be assigned a position with a start date in the current term, or if the school does not have any work study positions available as long as you have been awarded work-study
· Be responsible for the care of a child that you are applying for benefits with (specific age requirements apply)
· Be receiving cash assistance from DHS
· Be in a Workforce Investment Act (WIA) training program
· Be receiving unemployment compensation
· Be participating in one of the Employment Department training programs
You may request to speak with an eligibility worker about this decision. To talk with a worker about this decision, please contact:
Worker Name: XXXXXXXXXXXXXXXXXXXXXX
Phone number: XXX XXX-XXXX ext. XXX
Oregon Administrative Rule: 461-110-0370, 461-135-0570
If you disagree with this action, you have the right to a hearing.
Read Part 1 on the back of this form for more information.
NOTM,FS7832R
OFSET Referral Letter
This letter is for XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX.
Must check one: ABAWD XX non-ABAWD XX
ABAWD = 18 -49, no dependent child in the home
Oregon’s Food Stamp Employment Transition (OFSET) program can help you gain skills to get a job. You must work with the program to continue to get food stamps. You must keep all scheduled meetings. A meeting is set for an orientation with an OFSET contractor: