The individual may waive the ADH by signing a waiver form. The
individual suspected of an IPV, and the head of the SNAP household, if
different, may complete, sign and return the waiver form to the Department. By
completing, signing and returning the waiver form, the individual and the
household agree to all penalties and requirements, including repayment,
incumbent upon a household containing a member who is found guilty of an IPV at
an ADH.
The waiver form shall include:
(A) a statement that signing the form will
result in automatic disqualification and recoupment;
(B) the opportunity for the individual
accused of an IPV to admit or not to admit the charges cited in the ADH advance
notice;
(C) a statement that
neither the household nor the individual has the right to a subsequent fair
hearing on the same issue(s), nor on the amount of the claim;
(D) a statement that the remaining household
members will be held responsible for the claim even if the household
composition changes or the household stops participating in the
program;
(E) the name and telephone
number of someone who can be of assistance if the accused should wish to
discuss the charges, or the implications of the waiver;
(F) a place for the individual and the head
of household or authorized representative to sign the form;
(G) a statement that failure to sign and
return this form within the period specified by the Department will result in
the holding of an ADH;
(H) the
charge(s) against the household member;
(I) a summary of evidence and how and where
it can be examined;
(J) a listing
of the household member's rights as described in
106 CMR
367.400;
(K) a copy of the Department's ADH hearing
procedures; and
(L) a statement
that failure to return this waiver shall in no way have a negative impact on
the result of the ADH.
