Periodic Report Form (PRF)
7 CFR § 273.12(a)(5)(i) and (iii)(A)-(G)
All Applicable EDGs must complete a PRF once in the middle of their benefit period. EDGs with 12-month benefit periods must provide a complete report in the 6th month.
ImpaCT automatically generates the PRF. The complete report must be returned by the due date.
PRF Requirements
7 CFR § 273.12(a)(1)(i)-(iii) and (v)
The EDG must report the following changes on the PRF:
- Changes in earned income of more than $125 from the amount last used to determine the EDG’s benefits.
- Changes in unearned income of more than $125, except changes in TFA or SAGA benefits.
- Changes in the source of income, including starting or stopping a job, or changing jobs if the job change includes a change of income.
- Changes in household composition, such as the addition or loss of a member.
- When an ABAWD’s work hours are less than 80 hours per month (20 hours per week averaged monthly).
- Changes in residence (where the household physically lives), and the new residence’s shelter expenses.
- Changes in the amount of legally obligated child support.
- When a household receives lottery or gambling winnings equal to or greater than $4,500.
Complete PRF
7 CFR § 273.12(a)(5)(iii)(D)and(E) and CT Process
PRFs are complete when:
- the EDG reports "I made no changes" or "I reported changes", and
- if “I reported changes”, at least one change is reported on the form, and
- All pages of the PRF are received, and
- the form is signed and dated.
Note: regulations do not specify how the household must provide the date or that it must be a household provided date.
Register complete PRFs and process reported changes to take effect the month after the report month.
Advise the EDG of the action taken, including when:
- the benefit decreases,
- the benefit increases,
- the benefit remains unchanged, or
- the EDG is found ineligible.
Note: Provide adequate notice for decreases and case closures.
Changes Reported
7 CFR § 273.12(a)(5)(iii)(C)-(D) and (c)(1)-(3)
Act on reported changes as follows:
Change Increases Benefits
7 CFR § 273.12(c)(1)(i)-(ii)
Act on the reported change if the EDG provides required verifications.
Send the EDG a W-3016, Notification from the Department of Social Services, requesting any required verifications not provided with the PRF. Allow the EDG 10 days to verify the reported change.
Do not act on the reported change if the EDG fails to provide required verifications by the W-3016 due date. Verify and act on the change at renewal.
Change Decreases Benefits/Closes Case
7 CFR § 273.12(c)(2)(i)-(ii)
Act on the reported change. Verify the change at renewal if verification is not provided with the PRF.
No PRF Received
7 CFR § 273.12(a)(5)(iii)(E)
EDGs failing to provide a PRF by the due date are automatically mailed a Notice of Missing Report. The notice advises the EDG:
- they must complete and return the PRF and within the 10-day extended filing period after receipt of the notice, and
- their case will close unless they provide a complete PRF within the 10-day extended filing period.
ImpaCT automatically closes the case if the EDG doesn’t provide a complete PRF.
Incomplete PRF
7 CFR § 273.12(a)(5)(iii)(D)-(E)
Missing Signature
7 CFR § 273.12(a)(5)(iii)(E) and CT Process
ImpaCT automatically sends the EDG a Notice of Missing Signature and a Missing Signature sheet if the PRF is identified as “not signed”. The notice advises the EDG:
- the EDG must sign and return the Missing Signature sheet to complete the PRF process, and
- their case will close unless they provide a complete PRF within the 10-day extended filing period after receipt of the notice.
Questions Not Answered
7 CFR § 273.12(a)(5)(iii)(E)
Phone the EDG to obtain the answers to the unanswered questions. Enter case notes of the phone call and the EDG’s responses.
If the EDG could not be reached by phone, send the EDG a W-3016, Notification from the Department of Social Services, and the incomplete PRF with the unanswered questions highlighted. The notice advises the EDG:
- what questions the EDG must answer for the report to be complete,
- what required verifications the EDG must provide, and
- their case will close unless they provide a complete PRF within the 10-day extended filing period after receipt of the notice.
EDG Completes the Process within the 10-Day Extended Filing Period
7 CFR § 273.12(a)(5)(iii)(E)
Provide benefits no later than 10 days after their normal issuance if the EDG provides a complete PRF within the 10-day extended filing period.
EDG Files a Hearing Due to a Missing PRF
7 CFR § 273.12(a)(5)(iii)(F)
Reinstate the case if the EDG:
- requests a fair hearing claiming they filed a complete PRF but DSS doesn’t have the PRF, and
- a complete PRF is filed before the end of the issuance month.
EDG Completes the Process within 30 Days of Closure
Waiver of 7 CFR § 273.2(c) and (e)(1) & 7 CFR § 273.12(a)(5)(iii)(F)
Reinstate benefits when the EDG provides a complete PRF within 30 days after case closure. Reinstate benefits, effective the date the completed PRF is received, for the remaining months of the benefit period. Do not extend the benefit period.
A new application and interview are not required.
Prorate benefits from the date the PRF is returned complete.
An adequate notice W-0001N, Notice of Action, is sent to advise the EDG of the action taken on their reinstatement, including when:
- the benefit decreases
- the benefit increases,
- the benefit remains unchanged, or
- when the EDG is found ineligible.