Appendices

Appendix A: SNAP Worksheets

 SNAP Benefits Worksheet - Fillable PDF
Online SNAP Calculator

Appendix B: Income and Benefits Standards

 Income and Benefit Standards

Appendix C: SNAP Advocacy and DTA Documents

Important SNAP Advocacy and DTA Documents

 DTA FAX Cover Sheet (to send documents to Document Management Center)
 Sample Client Consent Allowing DTA to Release Information to Helping Agency
 Request to Choose Someone to be my Authorized Representative
 Request for an Appeal (Fair Hearing)
 Request to Employer for Employment Information (DORL-1)
 Community College Verification Form (CCE-1)
 College Educational Income and Expense Form EDUC-1
 Loss of Food/Household Misfortune Form for Replacement SNAP

Able-bodied Without Dependent (ABAWD) Fliers and Forms

 DTA ABAWD Medical Report Form
 DTA ABAWD Homeless Screening Form
 DTA Work Program Community Service Participation form
 MLRI FAQ on the SNAP time limit for ABAWDs

MLRI Know Your Rights Fliers and Client Materials

 Dependend Child Care Deduction and Sample Declaration
 Sample Client Declaration of Shelter Costs
 SNAP Medical Expense Deduction and Screening Form
 Adult and Child Foster Care Households

 College Student Eligibility
 SNAP Misfortune Replacement Benefits Power Outage/Food Loss
 3 Things You Need to Know about Photo EBT Cards

Appendix D: Cash and Food Stamp/SNAP Benefits for Noncitizens

Eligibility Charts by Immigration Status
DTA Brochure: What Noncitizens Need to Know

Appendix E: Legal Services

 Legal Services Office Listings
Find Legal Aid