SNAP Handbook
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Appendix A: Certification/Renewal Chart

Forms to Distribute/Complete

Type of Household or Income

Length of Period

PA 600

PA 600R

PA 564 (SAR FORM)

PA 253

PA 239SP

PA 10SFSP

PA 772*

Earned and/or unearned income, all adult members are not elderly or disabled

12 months

C

R

Yes

C & R

No

R

C & R

Migrant or seasonal farmworker

6 months

C

R

Yes

C & R

No

R

C & R

All adults are elderly/disabled and there may be earned income on the case

24 months

C

R

Yes

C & R

No

R

C & R

Unearned income only and all household members are elderly/disabled (ESAP FS 75)**

36 months

C

R

No

C & R

C & R

R

C & R

Zero-income households

6 months

C

R

Yes

C & R

No

R

C & R

ABAWDs

6 months or less

C

R

Yes

C & R

C & R

R

C& R

C = Certification
R = Renewal
* = Must be provided to clients who are nonexempt from work registration (see Chapter 535.3). It is not necessary to obtain a signature.

** = a PA 1935 can be used to apply for ESAP and a PA 1939 should be sent to renew for ESAP.

NOTE: Other specialized forms may be necessary.

Updated April 2, 2025, replacing February 16, 2023