SR 12-31 Dated 12/12

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases the Spanish language versions of the following forms to align with the corresponding English versions:

·   Form NHEP223(Sp), Spanish Version of Form NHEP223, Job Search Log;

·   Example Form NHEP223(Sp), Spanish Version of Example Form NHEP223, Job Search Log Example;

·   Participant Instruction Form NHEP223(Sp), Spanish Version of Participant Instruction Form NHEP223, Participant Instructions for Filling Out Form NHEP223;

·   Form NHEP232(Sp), Spanish Version of Form NHEP232, Work Experience Program (WEP) Agreement;

·   Form NHEP267(Sp), Spanish Version of Form NHEP267, Job Readiness Activity Verification Form;

·   Form NHEP269(Sp), Spanish Version of Form NHEP269, Client Statement for NHEP Non-Participation and Plan; and

·   DFA Form 808(Sp), Spanish Version of DFA Form 808, Proof Needed to Determine Your Assistance, and DFA Form 808(Ne), the Nepali version of this same form.

The Spanish language forms are identified by the suffix "(Sp)" immediately following the form number and the Nepali language forms are identified by the suffix "(Ne)" immediately following the form number.

POLICY

The Spanish versions of the forms released in this SR, and the single Nepali version, are now aligned with the corresponding English versions of these forms. Therefore, the SR number and date of the translated forms released in this SR will match the English versions of the forms. Because the Spanish and Nepali language versions of the forms released in this SR are used in the same manner as the English versions, no form instructions are being re-released.

All supplies of the old versions of these forms in the District Offices may be recycled upon receipt of the new versions.

IMPLEMENTATION

An initial supply of each of the translated forms released in this SR will be sent to each District Office as follows:

§   25 of each individual form to the Claremont, Concord, Keene, Laconia, Manchester, Southern, Seacoast, and Rochester District Offices;

§   10 copies of each individual form to the Berlin, Conway, and Littleton District Offices; and

§   10 copies of DFA Form 808(Ne) and DFA Form 808(Sp) to the Children’s Medicaid and Client Services Units.

Once copies of the newly translated forms released by this SR are received, District Offices may begin using the foreign language versions whenever the need arises. Reorder by contacting the Supervisor of the DFA Policy Development Unit and specifying the amount needed. The forms are also available electronically, for Department staff only, on the Lotus Notes Family Services Database. The following forms are also available on the DHHS website: Form NHEP223(Sp), Example Form NHEP223(Sp), Participant Instruction Form NHEP223(Sp), and Form NHEP269(Sp).

All supplies of the old versions of these forms in the District Offices may be recycled upon receipt of the new versions.

CLIENT NOTIFICATION

Clients will be provided with the newly released forms on an as needed basis.

TRAINING

No special training is planned or needed.

FORMS MANUAL POSTING INSTRUCTIONS

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the this SR has been posted to the On-line manuals.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at www.dhhs.nh.gov/DFA/publications.htm, effective December 31, 2012. Additionally, this SR will be distributed under separate cover to all internal hard copy holders of the Forms Manual.

DFA/JBV:s