A person must verify his or her statements. If a person does not provide adequate evidence or provides evidence that is not complete or not consistent, then he or she must cooperate with the CAO to determine what must be done to get acceptable evidence.
The person must try to get verification from third-party sources before the CAO takes responsibility for making a collateral contact.
At application and at renewal, the following persons will sign an Authorization for Release of Information, giving consent for the CAO to get information from collateral sources:
The applicant.
The payment name, regardless of age.
Any applicant or recipient age 18 or older.
Any emancipated minor applicant or recipient, 17 years of age or younger.
Note: The PA 4 is only verification of the applicant’s agreement to allow release of information. The signed application meets the requirement of giving consent to allow the release. However, if a third-party source refuses to provide collateral verification without a signed PA 4, persons who do not sign a PA 4 will be responsible to provide the CAO with all required verifications. The inability to provide all required verifications within 30 calendar days may cause benefit ineligibility for individuals or entire budget groups.
Signatures may be pending as follows:
At the application interview, the applicant will be requested to sign the PA 4. Other persons will be requested to sign the PA 4 within 30 calendar days of the benefit authorization date.
At the renewal interview, the person who is the payment name will be requested to sign the PA 4. Other persons will be requested to sign the PA 4 within 15 working days of the interview date.
A person added to an existing budget group will be requested to sign the PA 4 form within 15 working days.
The person who is the payment name will be requested to sign the PA 4 within 15 working days of a payment name change, a name change, or after an intercounty transfer is completed.
When a parent of a TANF child is serving in the uniformed service, the CAO will request the parent’s signature on the PA 4 when he or she returns home on leave.
The PA 4 provides a person’s consent for a third party to disclose information about the person’s age, residence, citizenship, employment, applications for employment, income, and resources. The CAO must retain the original of the signed PA 4 in the case record and give a copy of the form to any collateral contact who asks for written consent before disclosing information.
A person enrolled in SAR must attach verification of these items to the SAR form:
Earned income.
Unearned income, if changed.
Dependent care costs, if applicable to use as a deduction.
See Chapter 171 for information about specific requirements for Semiannual Reporting.
Reissued July 26, 2018; Replacing September 20, 2012