213 REQUIRED VERIFICATION (FSM)

____________________________________________________________

The individual must provide verification of factors affecting household composition if questionable.

Assist the individual in obtaining verification if the individual is incapable of providing it because of a mental or physical disability.

Questionable Factor	Acceptable Verification
Household size	• A signed statement by an individual residing outside of the household who knows the individuals in the household. - The statement must include a listing of the individuals in the household and their address.
Marital Status	• Original or certified copies of legal documents such as marriage licenses or divorce decrees. • Signed statements from relatives or individuals residing in the community. • Other similar verification.
Purchasing and preparing food separately	• A statement signed by all adults residing within the household. • A signed statement by an individual residing outside of the household who knows the individuals in the household. • A completed BFA Form 768, Shared Shelter Arrangements. • Other similar verification. In a situation in which it is an adopted child > 18 and < 22 who is now living with his or her birthparents, a signed statement, under penalty of unsworn falsification, that he or she purchases food and prepares meals separately from his or her birthparent.
Disability	If not apparent, a physician’s statement that the disability prevents the individual from purchasing and preparing food.
Income less than 165% of net monthly limit	See Chapter 500 , Income.

References: He-W 701.03; He-W 742.02; He-W 756.05; RSA 161:4-a,IV; RSA 641:3; 7 CFR 273.1; 7 CFR 273.2