108.4 Universal Notification

The CAO will provide applicants and recipients with information about:     

  55 Pa. Code § 108.3

 

  55 Pa. Code § 165.31   55 Pa. Code § 165.41

108.41 Notices and Displays

The CAO will:

108.42 Individual Notice

The CAO will provide oral notification to applicants and recipients of the right to claim good cause based on domestic violence as follows:      

 55 Pa. Code § 108.5(e)

Signs of abuse may include visible injuries, reluctance to share information about the non-custodial parent of the children, missed appointments, difficulty meeting work requirements, anxious behavior, or controlling or abusive behavior on the part of an accompanying partner.

CAO's will provide applicants or individuals who have not previously disclosed domestic violence with written notification. The Family Safety Notice and Domestic Violence Verification Form (PA 1747) is provided to inform the individual of the right to claim good cause based on domestic violence:    

  55 Pa. Code § 108.4    55 Pa. Code § 108.5

The Family Safety Notice is on the front and the Domestic Violence Verification form is on the back of the PA 1747. Information from the Family Safety Notice is also included on the PA 600 application.

NOTE: The PA 1747 is included with system-generated PA/FS 162 A or PA /FS 162 C notices and all manual notices sent to individuals in a non-DV case (DV indicator is checked No) who are subject to grant reduction, sanction, or budget closing for the following reasons:

This notice shall include an explanation of:       

55 Pa. Code § 108.5(d)

The PA 1747 is the written notice that provides information about domestic violence waivers for families facing denial, termination, reduction, or suspension of benefits or sanction.

NOTE:  The PA 1747 is handed to the individual in person prior to adverse action on the case. When this is not possible, the CAO confirms whether the individual has elected to use an alternate address (see Section 108.102, Alternate Address) before sending the notice. If it is not possible to hand the notice to the individual, there is no alternate address, and the individual has disclosed domestic violence, do not proceed with the adverse action.

Please refer to Section 108.81, Verification: Domestic Violence Verification Form (PA 1747) for instructions on how to complete the verification process.

The PA/CS 173 WP (Support and Good Cause Notice), must be provided to all applicants, provides information to assist individuals in evaluating whether they can pursue support safely or want to seek a waiver. 

The PA/CS 647 (Child Support Information Sheet), provides written notice of support requirements and includes Family Violence information.

The PA/CS 173 GC “Good Cause” Determination Based on Factors Other Than Domestic Violence for Child Support or Paternity: A good cause claim for reasons other than domestic violence, such as rape, incest or pending adoption proceedings.

The PA/CS 173 WP, PA/CS 173 GC, PA/CS 647, and PA 1747 are available on DocuShare.

 

Updated May 22, 2024, replacing August 9, 2021