18 Miss. Code. R. 14-2.3 - Required Application Notifications
Each application form must include the following:
A. Notice of a household's right to file with
an applicant's name, address and signature of a responsible household member or
the household's authorized representative.
B. Notice that, if eligible, benefits will be
provided from the date of application.
C. A description of expedited services on the
first page of the application.
D. A
statement to be signed under penalty of perjury as to the truthfulness of the
information contained in the application by an adult household
member.
E. A prominent description
of the civil and criminal penalties for violating the Food and Nutrition Act of
2008.
F. Notice that information
available through the income and eligibility system (IEVS) will be requested,
used, and may affect eligibility and benefit levels.
G. Notice that non-citizen status of
applicant household members may be subject to verification by United States
Citizenship and Immigration Services (USCIS) through the use of the Systematic
Alien and Verification and Entitlements (SAVE) system that may affect
eligibility and benefit levels.
H.
The USDA non-discrimination statement and the Privacy Act statement.
Notes
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