Machine Operator Quality Control

COMMONWEALTH OF KENTUCKY

Cabinet for Health and Family Services

Department for Community Based Services

Date: 06/26/2024

Case Number: 110012112

KIF-105.3

**/**

258042878

MELINDA F WILSON

** *OSTER LN

STANFORD, KY 40484-9548

Website: http://chfs.ky.gov 1 of 4 An Equal Opportunity Employer M/F/D Information About Your SNAP Benefits

Information about your SNAP benefits

We have reviewed your Supplemental Nutrition Assistance Program (SNAP) case. You will get benefits from July 01, 2024 until the end of October 31, 2024. We based our decision on the information you gave us.

Benefit Month/Year Benefit Amount

July, 2024 - August, 2024 $291.00

Information about your income and expenses

Gross Income (before taxes or deductions)

Earned(money from a job) $0.00

Unearned(money from other sources) $0.00

Expenses and Deductions

SNAP rules do not always allow us to count all the expenses you report. Here are your expenses and the amounts we were allowed to deduct: Actual Allowable

Earned Income (20% of gross earnings) $0.00 $0.00

Dependent Care $0.00 $0.00

Legal Child Support Paid $0.00 $0.00

Shelter/Utility $0.00 $0.00

Medical $0.00 $0.00

Case Number: 110012112 Date: 06/26/2024

Website: http://chfs.ky.gov 2 of 4 An Equal Opportunity Employer M/F/D Information about your household

Household Size 1

Income Limit $2,430.00

Remember!

The following changes must be reported no later than 10 days after the end of the month the change occurs:

When the gross income for your household size exceeds the income limit listed above; or When a member of your household age 18 through 52 years old, and subject to ABAWD requirements, has their work hours reduced to fewer than 20 hours a week. Gross income means the amount of all earned and unearned income before any deductions, such as taxes, are taken out.

You will get SNAP benefits for:

MELINDA F WILSON

Need help? Have questions?

To get help or ask questions, call 1-855-***-****. Need Legal help?

If you want legal help, you may be able to get free legal help from your local legal aid office at 1-866-***-****.

The table below lists the income limit used for July 2024 ongoing benefits Household

Size

1 2 3 4 5 6 7 8

Each

Additional

Member

Income Limit $2,430 $3,288 $4,144 $5,000 $5,858 $6,714 $7,570 $8,428 $858 Case Number: 110012112 Date: 06/26/2024

Website: http://chfs.ky.gov 3 of 4 An Equal Opportunity Employer M/F/D Report Changes:

You must report the following changes no later than 10 days after the end of the month the change occurs:

· When the income for your household exceeds the

gross income limit for your current household size; or

· When a member of your household age 18-52 years

old, and subject to work requirements, begins to work less than 20 hours per week.

· When a member of your household receives lottery or gambling winnings of $4250 or more.

Call DCBS at 1-855-***-**** to report any changes. DCBS accepts calls between 8:00 a.m. and 4:30 p.m. EST Monday through Friday and between 9:00 a.m. and 2:00 p.m. EST on Saturday.

Follow these rules:

• Do NOT give false information or hide information to get SNAP benefits.

• Do NOT trade or sell SNAP benefits.

• Do NOT use SNAP benefits to buy ineligible items, like alcoholic drinks, soap, tobacco products, firearms, ammunition, explosives, or a controlled substance as defined by 21 U.S.C. 802.

• Do NOT use your SNAP benefits for anyone outside of your benefit group OR use someone else’s SNAP

benefits for your household.

• Do NOT give someone your EBT card and PIN to use if they are not a member of your benefit group or an authorized representative.

• DO NOT use your SNAP benefits to pay on a credit account, even if it is for SNAP eligible food.

• Do NOT sell food purchased with SNAP benefits.

Penalties for breaking these rules:

You may be stopped from getting benefits and you may be prosecuted. You could be:

• Stopped from getting SNAP benefits for 1 year,

2 years, or permanently;

• Fined up to $250,000 or jailed up to 20 years,

or both; and

• Stopped from getting SNAP benefits for 10

years if you are found guilty of giving wrong

information about who you are or where you

live.

Giving wrong information on purpose may result in us taking criminal or civil legal action against you. It might also mean we reduce your benefits or take money back from you.

You have the right:

• To quick action whenever you report a change.

• To get notice of any action.

• To give us information to show the proposed action should not be taken.

• To discuss your benefits with a worker.

• To receive fair treatment.

Complaints about your case? Call the Ombudsman at

1-800-***-**** or (TTY) 1-800-***-****.

You have rights under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act.

Call DCBS at 1-855-***-**** if you have a physical or mental limitation, such as mental illness, trouble learning, drug or alcohol addiction, depression, moving around, hearing or seeing. Here are some ways we can help:

• We can call you if you are not able to come to our office;

• We can tell you what this letter means;

• If you cannot do something we ask, we can help you or change what you have to do;

• We can help you resolve problems without a hearing;

• We can help you request a hearing.

Do Not Send Applications Here

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), religious creed, disability, age, political beliefs, or reprisal or retaliation for prior civil rights activity. Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the agency (state or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at 800-***-****.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program

Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/ad-3027.pdf, from any USDA office, by calling 833-***-****, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to: 1. mail:

Food and Nutrition Service, USDA

1320 Braddock Place, Room 334

Alexandria, VA 22314; or

2. fax:

833-***-**** or 202-***-****; or

3. email:

************************@****.***

This institution is an equal opportunity provider. Do Not Send Applications Here

For any other information dealing with Supplemental Nutrition Assistance Program (SNAP) issues, persons should either contact the USDA SNAP Hotline Number at 800-***-****, which is also in Spanish or call the State Information/Hotline Numbers (click the link for a listing of hotline numbers by State); found online at

http://www.fns.usda.gov/snap/contact_info/hotlines.htm . You may also file your complaint with the Cabinet for Health and Family Services by writing or calling:

Office of Human Resource Management

EEO Compliance Branch

275 E Main St 5C-D

Frankfort KY, 40621

1-502-***-**** ext. 4107

How to get a Hearing:

Do you disagree with something we have done to your benefits? If so, you may ask for a hearing within 90 days from the date of this notice.

Want to continue your benefits?

Ask for a hearing within 10 days from the date of this notice. This may allow you to get the same benefits until the hearing officer makes a decision or your current certification period ends, whichever occurs first. You may have to pay back these benefits if the decision is not in your favor.

If you want your benefits to continue, please include the following sentence in your written request: “I want my same benefits continued.”

How do I ask for a hearing?

Call DCBS at 1-855-***-****; OR

Attach a separate sheet of paper to explain your reason for requesting a hearing, sign and date then:

Return to any DCBS office; OR

Return to:

Cabinet for Health and Family Services

Division of Administrative Hearings

Family and Children Administrative Hearings Branch 105 Sea Hero Rd, Suite 2

Frankfort, KY, 40601

What will happen at the hearing?

• You may tell your side of the story or bring a friend, relative, or lawyer to speak for you.

• You can bring witnesses and papers to help tell your story.

• The hearing officer will decide what the State will do after hearing both sides of the story.

• You will be told what to do if you disagree with the hearing officer’s decision.

Website: http://chfs.ky.gov 4 of 4 An Equal Opportunity Employer M/F/D Quality Control

· We are processing your case based upon

the proof and information that you provided

us.

· Quality Control (QC) randomly selects

cases for review to ensure that the benefits

are correct. If they choose your case, they

will contact you to ask questions and will

verify all information that you have provided.

If you don’t cooperate with QC, your

benefits may stop.

· Any benefits that are received incorrectly

must be paid back.

· If you give false information or fail to report

income* you may be prosecuted for fraud.

* Income includes all monies received by the household in any form. (For example: wages, self-employment, money from friends/family, etc.)

PAM-PAFS-343.2 (4/17)

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