SR 07-14 Dated 05/07 |
STATE OF NEW HAMPSHIRE
INTER-DEPARTMENT COMMUNICATION
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DFA SIGNATURE DATE: |
May 22, 2007 |
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FROM: |
OFFICE OF THE DIRECTOR, DFA Terry R. Smith |
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AT (OFFICE): |
Division of Family Assistance |
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TO: |
DFA Supervisors District Office Managers of Administration
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SUBJECT: |
Revised Form 754C, Request for TANF/UP Family/Domestic Violence Option, and Its Associated Instructions |
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EFFECTIVE DATE: |
May 25, 2007 |
SUMMARY
This SR releases revisions to Form 754C, Request for TANF/UP Family/Domestic Violence Option, and its associated instructions.
POLICY
Revisions to Form 754C, Request for TANF/UP Family/Domestic Violence Option, and its associated instructions, primarily focused upon adding text related to the Financial Assistance for the Unemployed Parent (UP) program as released by SR 06-12, dated October 2006.
All previous versions of the Form 754C remain valid, however, and may still be used by both TANF and UP recipients in requesting an extenstion to the 60-month limit on receipt of TANF/UP cash assistance or for special considerations with child support or in the New Hampshire Employment Program (NHEP).
POLICY MANUAL REVISIONS
No policy manual revisions were required as a result of changes to this form.
IMPLEMENTATION
The version of the Form 754C dated December 2002, SR 02-31, remains valid and any request submitted on this version must be treated accordingly. As such, a certificate of destruction has not been included in the SR for this form as the current stock is not to be destroyed or recycled. When the current stock is depleted, the new version will be printed.
CLIENT NOTIFICATION
No special notification is necessary. District Offices and clients will begin to use the new form upon receipt.
TRAINING
No special training is planned or needed.
FORMS POSTING INSTRUCTIONS
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Remove and Destroy |
Insert |
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Forms Manual
Form 754C, Request for TANF Family/Domestic Violence Option SR 02-31/December, 2002 1 sheet, 3-Part NCR |
Form 754C, Request for TANF/UP Family/Domestic Violence Option SR 07-14/May, 2007 1 sheet, 3-Part NCR |
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Form 754C(i), Instructions for Form 754C SR 93-49/August, 1993 1 sheet |
Form 754C(i), Instructions for Form 754C SR 07-14/May, 2007 1 sheet |
DISPOSITION
This SR may be destroyed or deleted after its contents have been noted and the SR has been posted to the On-line manual.
DISTRIBUTION
This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at http://www.dhhs.nh.gov/DHHS/DFA/LIBRARY, effective July 2, 2007.
This SR will be distributed under separate cover to all hard copy holders of the Forms Manual.
DFA/JBV:s