C-530, Form H1000-C, Secondary Client Input Instructions

Revision 05-4; Effective August 1, 2005

TANF and SNAP

Use Form H1000-C to enter start and end dates for PRA penalties and good cause. Form H1000-A and Form H1000-B must be submitted with Form H1000-C, but Form H1000-C is not always required when submitting Form H1000-A and Form H1000-B. SAVERR does not produce a turnaround for Form H1000-C.

C—530.1 Section I, Items 01 - 07

Revision 08-4; Effective October 1, 2008

Item 01: App. or Case No.

TANF and SNAP

Enter the application or case number.

Item 03: Seq. No.

TANF and SNAP

Enter the same sequence number from Form H1000-A and Form H1000-B.

Item 04: Pg. No.

TANF and SNAP

Enter the same page number the individual is listed on Form H1000-A and Form H1000-B.

Item 06: BJN

TANF and SNAP

Enter the employee's BJN.

Item 07: Mail Code

TANF and SNAP

Enter the office mail code.

Item 09: Case Name

TANF and SNAP

Enter the same case name from Form H1000-A and Form H1000-B.

C—530.2 Section II, Items 201 - 213

Revision 05-5; Effective October 1, 2005

Item 201: PAR. SKILLS

TANF

When an individual is referred or has completed Parenting Skills training, enter code

R — Eligibility referred the individual to parenting skills training, or

C — Eligibility verified that the individual completed parenting skills training.

SAVERR stores Code R or C on Client Screen A, Welfare Reform Data, under Parenting Skills status. In addition, the status of J appears in this SAVERR field when the Choices system verified that the individual completed parenting skills training as a Choices component.

Items 202, 205, 208, and 211: TYPE

TANF

When starting or ending a penalty or good cause, enter the following codes in these Items

Penalty Codes

Code or Action	Definition
T	Third or subsequent noncooperation with Choices
S	Second noncooperation with Choices
F	First Noncooperation with Choices
C	Child Support
V	Voluntary Quit
E	Texas Health Steps
G	Immunizations
M	School Attendance - child
P	School Attendance - minor parent
D	Alcohol or Drugs
U	Unidentifiable penalty - Use this code when making Section XI entries only and the benefit is being reduced by more than one penalty.

Good Cause Codes

Code or Action	Definition
1	Individual is on an alternate schedule for immunizations
2	Good cause for immunizations due to medical reasons
3	Good cause for immunizations due to conscientious objection
4	Grace period
6	Good cause for noncooperation with Texas Health Steps
7	Good cause for noncooperation with Parenting Skills Training

Note: Good cause Code 5 is sent through the Choices automated system.

Items 203, 206, 209, and 212: Start

TANF

Enter the month and year the penalty starts. At application, start a child support or voluntary quit penalty beginning the application month.

On incomplete and complete reviews, the start date cannot be earlier than three months before the current cutoff month or later than the next SAVERR effective month.

Items 204, 207, 210, and 213: End

TANF

Enter the month and year the penalty ends.

SAVERR does not allow entry of future end date. The end date cannot be later than the SAVERR effective month.

C—530.3 Section III, Items 214 - 215

Revision 09-4; Effective October 1, 2009

Item 214: FIC (R/E) (Finger Image Code)

TANF and SNAP

Enter finger image codes for required individuals at application and at complete review/recertification, including simultaneous open and close transactions. Finger image codes are not required on denials or Temporary Assistance for Needy Families (TANF) complete reviews with a future action code of a denial.

If the correct finger image code is not already on the System for Applications, Verifications, Eligibility Reports and Referral (SAVERR), enter a finger image code for each household member who is:

age 18 or older as of the interview date;
a minor parent (secondary SIG L) on a TANF case with a dependent child on the same case; or
a minor head of household (SIG A) on a Supplemental Nutrition Assistance Program (SNAP) case.

Enter one of the following finger imaging codes:

Imaging Code	Definition
Y	All available images have been taken.
Z	One image has been taken (Note: This includes a finger image that Lone Star Image System (LSIS) determines to be temporarily unavailable because of low quality.)

Enter one of the following exemption codes:

Exemption Code	Definition
A	Appeal pending (TANF related)
B	Low quality image, physically unable to image or equipment failure
C	Certified out of office or unable to travel to the LSIS site to be imaged
D	Undue burden for disabled individual
E	Undue burden for elderly individual
F	Disqualified (SNAP only) Note: If SAVERR has no finger imaging code and Form H1000-C, Secondary Client Input, has no entry, the finger imaging code defaults to F for individuals with SIG G, or SIG K or T when the individual is over 18.

On expedited SNAP cases for required members:

present at the interview, enter the appropriate
- finger image code and vendor unique number (VUN); or
- finger imaging exemption code.
not present at the interview, allow Code C until the next recertification or reapplication.

Automated Changes

The advisor cannot change Codes I or Y on Form H1000-C. SAVERR performs this automated conversion as described in the following chart.

If the individual's status changes from ...	and SAVERR has code ...	then SAVERR ...
inactive to active	I	changes the code to Y, and sends a message to LSIS to remove the archive date.
active to inactive	Y	changes the code to I, and sends a message to LSIS to set the archive date.

SAVERR also sends a message to LSIS to set the archive date on inactive individual records with Code Z, but does not change the code.

SAVERR automatically deletes the finger Code I or Z when LSIS notifies SAVERR that it purged the finger image record. The LSIS purges the finger image record after the individual is inactive for 12 months.

Changing, Correcting or Deleting Finger Image Codes

Finger image exemption codes remain on SAVERR until it purges the individual record.

If the advisor needs to change ...	to ...	then ...
Code Z	Code Y,	enter the new code on Form H1000-C.
an exemption code	Code Y,	enter the new code and VUN, on Form H1000-C.
an exemption code	another exemption code,	enter the new code on Form H1000-C.
Codes Y or Z	an exemption code,	deletes the Y or Z through the force change process using Form H1075, Welfare Reform Force Change Request, for TANF individuals or Form H1074, SNAP Force Change Request, for food benefit individuals, and enter the new code on Form H1000-C after the forced change processes.
Code I	an exemption code	follow the procedures listed above for Codes Y and Z, or allow the vendor's automated purge process to delete the code if the LSIS record is approaching its archive date.

Item 215: Vendor's Unique Number

TANF and SNAP

If the entry in Item 214 is Y or Z, enter the nine-digit VUN.

The VUN contains a "check digit," an automated aid for validating data. If the check digit indicates the advisor did not enter the VUN correctly, Form H1000-C will not process.

SAVERR does not store the VUN, but uses it to associate the SAVERR client number with the finger image record on the vendor's system.

C—530.4 Section IV, Items 216 - 223

Revision 07-4; Effective October 1, 2007

Item 216: ADD

SNAP

Enter the code(s) to indicate that an individual is being disqualified for one or more of the following reasons, even if the disqualification results in case denial. Once entered, these codes remain on the System for Applications, Verifications, Eligibility Reports and Referral (SAVERR) until removed by an entry in Item 217.

Code or Action	Definition
B	Ineligible alien without a U.S. Citizenship and Immigration Services (USCIS) document
C	Ineligible aliens with USCIS document
D	Felony drug conviction
F	First offense failure to comply with Employment Services Program (ESP) requirements (employment and training/voluntary quit/reducing work hours to less than 30)
J	Fugitive
N	Failure to meet the Social Security number (SSN) requirement
S	Second offense failure to comply with ESP requirements
T	Third or subsequent offense failure to comply with ESP requirements
W	Failure to comply with the 18-50 work requirement

Note: Send Form H1074, SNAP Force Change Request, to correct SAVERR information on:

active individuals to delete the drug disqualification code; or
denied individuals to add or delete a disqualification code or change the employment and training/voluntary quit counter.

Item 217: Remove

SNAP

Enter a code below to remove a code, end a specific type of disqualification or change a Supplemental Nutrition Assistance Program (SNAP) time-limited benefit code. Enter one of the following codes to indicate the action needed.

Code or Action	Definition
1	Delete the first countable month
2	Delete the second countable month
3	Delete the third countable month
4	Delete the fourth countable month (first month of second three month period)
B	End the ineligible alien (undoc) disqualification
C	End the ineligible alien (doc) disqualification
F	End the first offense SNAP ESP disqualification
J	End the fugitive disqualification
L	Subtract one offense from the ESP offense counter (when entering code L, do not enter Code F, S or T in Item 216 on the same Form H1000-A, Notice of Application, Form H1000-B, Record of Case Action and Form H1000-C, Secondary Client Input, transaction) N — End of the SSN disqualification
N	End of the SSN disqualification
S	End the second offense SNAP ESP disqualification
T	End the third offense SNAP ESP disqualification
W	End the 18-50 work requirement disqualification

Items 218 - 223

SNAP

Make entries in these fields to report that HHSC has authorized a SNAP benefit for accountable month of the initial or second three-month period of time-limited benefits in a 36-month period for an individual age 18-50. Make entries of Code(s) 1-4 in Items 218 and the corresponding month(s) in Item 219.

Items 220-223 can be used on the same Form H1000-A,Form H1000-B and Form H1000-C transaction when necessary to simultaneously report up to three months of countable issuances. If the advisor needs to report four months simultaneously, the fourth month (first month of second three-month period) must be reported on a subsequent Form H1000-C.

SAVERR does not automatically update the months of countable time-limited SNAP benefits received by an individual age 18-50. The advisor must update SAVERR each time when submitting Form H1000-A, Form H1000-B and Form H1000-C.

Staff do not have to enter the last month of the 36-month period. SAVERR computes it based on the months entered by the advisor as the first countable month of the initial three-month period of time-limited benefits, and displays it on inquiry.

On the same Form H1000-C, staff can delete months using Item 217 and enter corrected months in Items 218-223.

Item 218: Code (Countable Month Code)

SNAP

Enter one of the following codes and a corresponding month in Item 219:

Code or Action	Definition
1	Benefit authorized for the first month of the initial three-month period
2	Benefit authorized for the second month of the initial three-month period
3	Benefit authorized for the third month of the initial three-month period
4	Benefit authorized for the first month of the second three-month period

Item 219: Month (Countable Month MMYYYY)

SNAP

Enter the month and year corresponding to the code entered in Item 218. The month cannot be greater than the SAVERR effective month.

Item 220: Code (Countable Month Code)

SNAP

If more than one month needs to be reported on the same Form H1000-A, Form H1000-B and Form H1000-C, enter the appropriate code (2, 3 or 4) to indicate that HHSC has authorized a SNAP benefit for a second, third, or fourth (first month of second three-month period) countable month. Enter a corresponding code in Item 221.

Item 221: Month (Countable Month MMYYYY)

SNAP

Enter the month and year corresponding to the code entered in Item 220. The month cannot be greater than the SAVERR effective month.

Item 222: Code (Countable Month Code)

SNAP

If more than two months needs to be reported on the same Form H1000-A, Form H1000-B, Form H1000-C, enter the appropriate Code 3 or 4, to indicate that HHSC has authorized a SNAP benefit for a third or fourth countable month. Enter the corresponding month in Item 223.

Item 223: Month (Countable Month MMYYYY)

SNAP

Enter the month and year corresponding to the code entered in Item 222. The month cannot be greater than the SAVERR effective month.

C—530.5 Section V

Revision 02-3; Effective April 1, 2002

Item 190: Emp. No.

TANF and SNAP

Enter employee number of staff member completing form.

C—540 Code Summary

Revision 08-4; Effective October 1, 2008

TANF and SNAP

This section contains a Form H1000-A, Notice of Application, Form H1000-B, Record of Case Action, and Form H1000-C, Secondary Client Input, instructions code summary.

Item 02: Category

TANF

Code or Action	Definition
2	TANF
5	Refugee Cash Assistance (RCA)

SNAP

Code or Action	Definition
6	Public Assistance (PA) SNAP Case
8	Refugee, PA SNAP
9	Non-PA SNAP Case

Item 03: Sequence No. (SEQ)

TANF and SNAP

Code or Action	Definition
Y	Yes

Item 27: Modifier (M)

TANF

Code or Action	Definition
P	Protective Payee
R	Representative Payee

SNAP

Code or Action	Definition
I	Authorized representative (AR) is a member of household (under the same roof).
O	AR is not a member of household (not under the same roof).
F	AR is an employee of a drug and alcohol treatment or group living arrangement facility.

Item 28: Indicator Code

TANF

Code or Action	Definition
M	Incapacity

TANF-UP

Code or Action	Definition
U	(system entered when TP 61 transfers to TP 07, 20 or 37)

SNAP

Code or Action	Definition
1	Streamlined reporting (SR) household with total gross monthly income that is less than or equal to 130% of the Federal Poverty Income Limits (FPIL).
2	SR household with total gross monthly income that is greater than 130% FPIL.
3	Non-SR household.

Item 32: Client Number

TANF and SNAP

Code or Action	Definition
2	Check for an existing number.

Item 35: Sex

TANF and SNAP

Code or Action	Definition
M	Male
F	Female

Item 36: Race

TANF and SNAP

Code or Action	Definition
1	White
2	Black
3	Hispanic
4	American Indian or Alaskan Native
5	Asian or Pacific Islander (includes Indochinese)
6	Computer entered code indicating inappropriate or omitted code. Must be corrected.

Item 39: Education or Service Code

TANF and SNAP

Code or Action	Definition
1	First Grade
2	Second Grade
3	Third Grade
4	Fourth Grade
5	Fifth Grade
6	Sixth Grade
7	Seventh Grade
8	Eighth Grade
9	Ninth Grade
A	Tenth Grade
B	Eleventh Grade
C	High School Graduate or completed general equivalency diploma
E	Attending college or completed some college but has not graduated from a four-year college
F	Graduate of a four-year college
N	No formal education

Item 40: Status in Group

TANF

Primary Codes

Code or Action	Definition	If the child receives ...	then enter SIG Code
2	Disqualified or ineligible child or second parent
3	Noncertified child: Identifies the only deprived child of the certified caretaker or second parent	SSI Foster Care Payments Adoption Assistance payments	3 3F 3A
5	Certified Child
7	Second Parent
8	Caretaker
9	Payee
0	Case Name Only

Secondary Codes

Code or Action	Definition
G	Reached End of Time Limit
H	Eligible Refugee
I	Ineligible Child
K	Child of a Minor Child
L	Minor Parent with a Dependent Child
M	Eligible Only for Three Months Prior Medical Assistance
N	Ineligible for Retroactive Medical Assistance and Current Assistance
P	Private Health Insurance
Q	Proof of THSteps Screening
R	HHSC Employee
S	Alien with Acceptable Alien Status
T	Ineligible Alien
U	Ineligible - No Citizenship Proof
V	Living in Nursing Home
W	Disqualified Child
X	Deceased
Y	Disqualified Second Parent
Z	Migrant

SNAP

Head of Household Codes

Code or Action	Definition
A	Household head
G	Household head is nonmember
GK	Head of household disqualified for a reason other than an IPV
GT	Head of household is disqualified for intentional program violation (IPV)

Other Codes

Code or Action	Definition
A	Child (SIG 5 or 5L)
B	Caretaker or second parent, age 18 or younger attending school
C	Caring for an ill or disabled child in the household, even if the child is not a member of the certified group
E	Unable to work due to a disability expected to last more than 180 days
F	60 years of age or older
G	Caring for a child (SIG 2, 3, or 5) under age 1
H	Presence required in home due to illness or incapacity of another adult household member and the disability is expected to last more than 180 days
J	Not subject to participation – not a certified TANF individual
K	Pending during appeal of denial or disqualification
L	County Hardship Exemption
M	Mandatory registrant
N	Employment Hardship Exemptions
P	Mandatory registrant employed or self-employed 30 or more hours per week and earning at least $700 a month
Q	Severe Personal Hardship Exemption
R	Caring for child under age 1 who is not listed on Form H1000-A, Form H1000-B and Form H1000-C
T	Pregnant and unable to work
U	A single grandparent age 50 or over caring for a child under age three
V	An SSI recipient parent.
W	Identifies a individual who noncomplies with the Choices program
X	A parent who has exhausted state time limits.
Y	A parent who is disqualified due to third party resource (TPR) requirements, Social Security number requirements, intentional program violation, failure to report a child’s absence, being a fugitive, having a felony drug conviction, failure to cooperate with Quality Control or noncompliance with the unmarried minor parent domicile requirement.

B — Student

C — ABAWD not meeting 18-50 work requirement

D — ABAWD meeting 18-50 work requirement

F — Resident of drug and alcohol treatment/group living arrangement facility

H — Eligible Refugee

K — Disqualified for a reason other than IPV

M — Migrant, out of work stream

R — HHSC Employee

S — Eligible Alien (not a refugee)

T — Disqualified for Intentional Program Violation

U — Seasonal Farm Worker

W — Migrant, in work stream

Item 41: Employment Services/Work Registration

TANF

Code or Action	Definition
A	Child (SIG 5 or 5L)
B	Caretaker or second parent, age 18 or younger attending school
C	Caring for an ill or disabled child in the household, even if the child is not a member of the certified group
E	Unable to work due to a disability expected to last more than 180 days
F	60 years of age or older
G	Caring for a child (SIG 2, 3, or 5) under age 1
H	Presence required in home due to illness or incapacity of another adult household member and the disability is expected to last more than 180 days
J	Not subject to participation – not a certified TANF individual
K	Pending during appeal of denial or disqualification
L	County Hardship Exemption
M	Mandatory registrant
N	Employment Hardship Exemptions
P	Mandatory registrant employed or self-employed 30 or more hours per week and earning at least $700 a month
Q	Severe Personal Hardship Exemption
R	Caring for child under age 1 who is not listed on Form H1000-A, Form H1000-B and Form H1000-C
T	Pregnant and unable to work
U	A single grandparent age 50 or over caring for a child under age three
V	An SSI recipient parent.
W	Identifies a individual who noncomplies with the Choices program
X	A parent who has exhausted state time limits.
Y	A parent who is disqualified due to third party resource (TPR) requirements, Social Security number requirements, intentional program violation, failure to report a child’s absence, being a fugitive, having a felony drug conviction, failure to cooperate with Quality Control or noncompliance with the unmarried minor parent domicile requirement.

SNAP

Code or Action	Definition
A	Child age 16 years of age or child age 16 or 17 who attends school at least half-time, or is not the head of household
D	Three to nine-months pregnant
E	Physically or mentally unfit for employment
F	60 years of age or older
G	Caring for a child under age six
H	Presence in home required for care of an incapacitated person
J	Person in drug addiction or alcoholic treatment and rehabilitation program
N	Receiving or applying for unemployment compensation
P	Employed or self-employed 30 hours or more a week
Q	Individual resides in a Choices county and is mandatory or has volunteered for TANF employment services
R	Registered again, after previously serving the E&T noncompliance penalty period
S	Student exemption (age 18 or older/in a training program)
T	Disqualified household member or nonmember head of household
U	Primary wage earner failed to comply with SNAP employment services
2	Registered, employed less than 30 hours a week
3	Registered, not working
4	Registered, job attached (temporarily laid off)
5	Registration postponed, expedited service

Item 42A: Type Income

TANF and SNAP

Code or Action	Definition
A	Veteran's Administration (VA) benefits
C	Unemployment Insurance benefits
P	Pension benefits (other than RSDI, SSI, VA or RR)
M	Combination of unemployment benefits with benefits from a pension, VA, or both
W	Combined income from VA and a pension

Item 49: Disqualification Code (Intentional Program Violation)

SNAP

Code or Action	Definition
1st digit	T – Administrative disqualification for offense which occurred prior to September 22, 1996 S – Administrative disqualification for offense which occurred on or after September 22, 1996, or disqualification for conviction due to trafficking C – Court-ordered disqualification M – Disqualification due to receipt of multiple benefits in one month.
2nd digit	1 – 1st disqualification 2 – 2nd disqualification 3 – 3rd disqualification 4 – permanent disqualification for trafficking in SNAP benefits or program access devices of $500 or more.
3rd – 6th digits	MMYY – last month of disqualification PERM – disqualification permanent

Item 50: Error Messages

TANF and SNAP

The following format is used for all error messages: AAABBCCC

Error Message	Definition
AAA	Form Item number 001-191; client Items 32-50 will be shown A32-K32, through K50. When a client Item is shown without line indicator, 032-050, then the comparison of all entries within that Item caused the error.
BB	One of the following two-digit qualifiers: EC – ERROR CODE NUMBER"CCC" EQ – EQUAL GE – GREATER THAN OR EQUAL GT– GREATER THAN LE – LESS THAN OR EQUAL LT – LESS THAN NA – NOT ALLOWABLE WITH THE ENTRY OR LACK OF ENTRY IN "CCC" NE – NOT EQUAL
CCC	Form Item number 001-191; or error code number 300-999; or one of the following "KEY" words: ALP – ALPHABETIC BLK – BLANK CUR – CURRENT PROCESS MONTH DAT – VALID DATE FIL – VALUE ALREADY ON FILE N-3 – today minus 3 months N-6 – today minus 6months N12 – today minus 12 months N24 – today minus 24 months N45 – today minus 45 days NAM – NAME FORMAT NOW – PROCESS DATE OF FORM NUM – NUMERIC NXT – NEXT PROCESS MONTH VAL – VALID

Error Message

Definition

AAA

Form Item number 001-191; client Items 32-50 will be shown A32-K32, through K50. When a client Item is shown without line indicator, 032-050, then the comparison of all entries within that Item caused the error.

One of the following two-digit qualifiers:

EC – ERROR CODE NUMBER"CCC"
EQ – EQUAL
GE – GREATER THAN OR EQUAL
GT– GREATER THAN
LE – LESS THAN OR EQUAL
LT – LESS THAN
NA – NOT ALLOWABLE WITH THE ENTRY OR LACK OF ENTRY IN "CCC"
NE – NOT EQUAL

CCC

Form Item number 001-191; or error code number 300-999; or one of the following "KEY" words:

ALP – ALPHABETIC
BLK – BLANK
CUR – CURRENT PROCESS MONTH
DAT – VALID DATE
FIL – VALUE ALREADY ON FILE
N-3 – today minus 3 months
N-6 – today minus 6months
N12 – today minus 12 months
N24 – today minus 24 months
N45 – today minus 45 days
NAM – NAME FORMAT
NOW – PROCESS DATE OF FORM
NUM – NUMERIC
NXT – NEXT PROCESS MONTH
VAL – VALID

Error Codes

Code or Action	Definition
300	Either the first digit of application number is not A or the last eight digits are not numeric
301	By changing the A of the application number to zero, it was found that a case already on file has been assigned that number.
304	Application already disposed
305	BJN was incorrect
307	The case or individual indicated is already active in the same program area for the benefit period requested.
308	The client number entered cannot be reassigned due to a mismatch of client information.
309	Multiple entries for this Item contained the same value.
320	A SNAP denial cannot precede a benefit issuance month.
321	The ATA issuance exceeded the maximum allotment for household size.
400	The individual's SSI coverage was changed to Suspense
402	Hierarchy of individual information prevented the use of the client entries on the transaction.
403	The entry made in Adjusted Gross Income is zero. Determine if the correct income was entered.
404	Valid entries for case number reassignment are required.
500	The rejection of this attempted denial caused the case to be placed on hold.

Item 78: Type of Review

SNAP

Code or Action	Definition
C	Complete review
I	Incomplete review
N	Non-review activity (case maintenance)

Item 79: Application Codes

SNAP

Code or Action	Definition
First Digit – Application Type	1 – Eligibility Determination 2 – Redetermination 3 – Application reopened after denial
Second digit	Enter X
Third digit – Number of Months	0 – All initial applications, reapplications within 30 days from previous application, or later applications within 30 days after the end of the previous certification period. 1-8 – Enter the number of months, as appropriate, since the last application or certification period. 9 – Nine months or longer since the last application or certification period.

Item 84: AID

SNAP

Code or Action	Definition
1	NPA Only
2	NPA Mixed
3	TANF-PA
5	Refugee, PA

Item 85: Test (Income Test or Shelter Deduction Identifier)

SNAP

Code or Action	Definition
B	Gross and net income tests with capped shelter deduction.
C	Categorically eligible household with capped shelter deduction.
E	Gross and net income test and uncapped shelter deduction. Use this code only if the member who is entitled to uncapped shelter costs is disqualified for intentional program violation.
M	Net test only, uncapped shelter deduction.
T	Categorically eligible household with uncapped shelter deduction. Note: This code is also used in situations where a household member, disqualified for any reason, is the only elderly or disabled member.

Item 87: NON (Non H/H Members)

SNAP

Code or Action	Definition
A	Attendant
B	Boarders
C	Ineligible alien
D	Ineligible student
E	Any combination of two or more of A, B, C, or D

Item 89: SSI

SNAP

Code or Action	Definition
X	Every household member receives SSI

Item 90: Util (Utility Expense Code)

SNAP

Code or Action	Definition
1	Household claiming the Standard Utility Allowance.
2	Household claiming telephone standard only, or telephone standard plus actual utilities.
3	Household claiming actual utility costs only (even if some members are disqualified).
4	Household without utility costs.
5	Two households live together and share the standard utility allowance.
6	Households claiming the standard utility allowance with member(s) disqualified for not meeting the citizenship, 18-50 work, and or SSN requirements.
7	All other proration situations. A combination of households described in Codes 5, 6, B, and C, a prorated telephone standard, and all other situations in which the utility allowance is prorated (such as a proration involving three or more households, or more than one disqualified member).
8	Household claiming the homeless shelter standard.
9	Household claiming the homeless shelter standard with one member who is disqualified for not meeting the citizenship, 18-50 work or SSN requirements.
A	Households claiming the basic utility allowance.
B	Two households live together and share the basic utility allowance.
C	Households claiming the basic utility allowance with member(s) disqualified for not meeting the citizenship, 18-50 work or SSN requirement.

Codes 1, 2, 3, 4, 5, 7, A, and B are allowed for household containing member(s) disqualified for an intentional program violation, felony drug conviction, E&T non-compliance, and/or being a fugitive.

Codes 3, 4, 6, 7, 9, and C are allowed for households containing member(s) disqualified for not meeting the citizenship requirement, 18-50 work requirement, or SSN requirement. Also, these codes are allowed for household containing member(s) disqualified for an intentional program violation, felony drug conviction, E&T non-compliance, and/or being a fugitive and member(s) disqualified for citizenship, 18-50 work requirement, and/or SSN requirements. Note: Utility, homeless, and telephone standards, if used, are prorated for these kinds of disqualifications.

Item 91: Action Code

SNAP

See C-221, Denial Codes.

Item 95: Code or Hold Date

SNAP

Hold Codes

Code or Action	Definition
2	Hold benefits
A	Form H1000-B has fatal error not cleared by cutoff
Z	Dormant EBT account (state office use)

Release Codes

Code or Action	Definition
0	Do not hold future benefits.

Item 101: Prepared Meals Services Code

SNAP

Code or Action	Definition
C	SSI or elderly member authorized to purchase from communal dining facilities, meal delivery service, or contracted restaurant
E	Homeless and either elderly or SSI recipient; authorized to purchase from every service (communal dining, meal delivery services, or homeless meal providers and contracted restaurants)
H	Authorized to purchase from homeless meal providers/contracted restaurants
M	Household or disabled member authorized to purchase from meal delivery services

Item 104: Special Review Code

SNAP

Enter the appropriate code to show the type of special review needed.

Code or Action	Definition
0	State office assigned
1	Employment Services or Work Registration
2	School Attendance
3	Reserved
4	Management
5	Income or Expense changes anticipated
6	Living arrangement change anticipated
7	Medical review
8	Household change anticipated
9	Other

Item 127 Type Program

TANF

Code or Action	Definition
01	Cash and medical assistance
04	Medical Assistance Only – Deceased
07	12 or 18 months medical assistance only
11	Three months prior medical assistance only not currently eligible
20	Medical assistance only – Child Support
37	12 or 18 months medical assistance only
61	TANF-UP cash and medical assistance
71	OTTANF – One parent household
72	OTTANF – Two parent household

Item 131: Type Review

TANF

Code or Action	Definition
C	Complete review
I	Incomplete review
N	Non-review activity (case maintenance)

Item 132: Action Code

TANF

See C-200 for Item 132 Codes.

Item 138: (Child Support Cooperation or Reason for Transfer to TP 07/20)

TANF

Code or Action	Definition
R	Refusal without good cause to cooperate with child support for one or more APs
X	Exempt from child support requirements, or claiming good cause for all APs
C	Cooperation. Enter this code if Codes R or X do not apply
E	new or increased earned income or earnings of a returning absent parent who is added to the certified group
S	new or increased child support collections
B	TANF denial results from a reason listed under Code E and new or increased child support collections

Item 140: Code

TANF

Code or Action	Definition
1	Employment Services/Work Registration (TANF only)
2	School attendance
3	(Reserved)
4	Management
5	Income/Expense changes anticipated
6	Living arrangement change anticipated
7	Medical review
8	Household change anticipated
9	Other
Q	Disability Hardship Exemption (TANF only)

Item 142: Hold CD: Date

TANF

Advisor Hold Codes

Code or Action	Definition
1	Unable to locate
2	Guardianship pending
3	New payee pending
4	Notice of adverse action to lower benefits that expires between cutoff and the end of the month
5	Notice of adverse action expires between cutoff and end of month (case denial or transfer to TP 07 or TP 20)

State Office Hold Codes

Code or Action	Definition
A	Hold, Form H1000-B has fatal error not cleared by cutoff
C	Form H3087 returned, moved
D	Form H3087 returned, deceased
E	Form H3087 returned, unclaimed
F	Warrant Undeliverable and returned by post office
G	Warrant undeliverable because individual is deceased
H	TANF case has SIG 5 member age 19 or over
L	State time limit expiring and SAVERR cannot rebudget TANF
J	Warrant charged back
R	SDX hold
Z	Dormant EBT account
3	RCA case has a member who entered the United States eight months ago
6	TANF case pending denial or transfer to TP 20

Advisor Release Codes

Code or Action	Definition
8	Release benefits as originally authorized
9	Release benefits as originally authorized using the new address on this Form H1000-B
0	Release future benefits. Use Form H1008 to release any returned benefits. Use Section XI to issue benefits for months on hold.

Item 149: Code

TANF

Code or Action	Definition
C	Dependent care deduction
9	A 90% earned income deduction up to $1400 per employed member or 12 or 18 months additional Medicaid coverage. This entry requires an entry on the same line in Item 151.

Item 179 - Type of Warrant Requested

TANF

Code or Action	Definition
1	Full months amount
2	Additional amount for a month; Form H1000-B use only

SNAP

Code or Action	Definition
S	Reporting ATA issuance untimely
E	Requesting issuance or timely reporting benefits issued via the ATA
N	Requesting cancellation of benefits

Item 180: Type Issuance

TANF

Reason for authorization of benefits

Code or Action	Definition
9	Action Code 090, simultaneous open and close on Form H1000-A only
B	Change in both household composition and money reflected in the budget
H	Change in household composition
M	Change in money reflected in the budget
O	Retroactive or current month's benefit when releasing a case from hold with release Code 0 or 7 in Item 142
P	Budgeting process requires different payment month benefits. Enter Code 1 in Item 179
R	(State office use only) Identifies on the history file benefits produced when release Code 8 or 9is used to release a case from hold
T	Transfer from TP 07, 20, 29, or 37 to TP 01/61 (Form H1000-B and Form H1000-C use only)

SNAP

Full Regular Ongoing Benefits or Their Replacements

Code or Action	Definition
A	Initial benefit (regular ongoing benefit)
E	Initial expedited benefit issued*
H	Priority benefits issued to meet hearing officer decision timeliness
L	Restoring benefits for a past month
1	Initial expedited benefits issued through ATA*
2	Priority benefits issued through SAVERR or ATA to meet timeliness
3	Initial priority benefits issued through ATA*
4	Historical Information: CCDMI mailed out of state as a result of converting EBT benefits to coupons (state office use only). No longer in use effective April 1, 2004.
5	Historical Information: Benefits replaced in EBT account when CCDMI was returned (state office use only). No longer in use effective April 1, 2004.

*See details in C-500, Item 180 instructions.

Additional Benefits for a Month

Code or Action	Definition
C	Supplemental benefits. Use when providing benefits in addition to initial benefits for the current month, or following month if submitting Form H1000-A, Form H1000-B and Form H1000-C after cutoff.
D	Restoration benefits. Use when restoring partial benefits for a past month.
F	Supplemental or restoration benefits. Use when providing additional benefits for a month in which the household has already received one issuance coded C or D.
P	Restore an erroneously expunged EBT benefit.

Destroyed Food

Code or Action	Definition
T	Replacement of destroyed food, which was purchased with SNAP benefits

Advisor enter cancellation

Code or Action	Definition
G	Use to cancel EBT benefit because the household has moved out of state

Item 186: Other Data (Range Code)

SNAP

Code or Action	Definition
P	Initial month benefit prorated

Benefit Range Code for all issuances coded C, D, F, H, P, or T in Item 180.

Range Code	Issuance Dollar Amount	Range Code	Issuance Dollar Amount
A	1 - 49	H	350 - 399
B	50 - 99	J	400 - 449
C	100 - 149	K	450 - 499
D	150 - 199	L	500 - 549
E	200 - 249	M	550 - 599
F	250 - 299	X	600 or over
G	300 - 349	-	-

Item 187: Household Composition for Benefit Requested

TANF

1st digit - Number of individuals with status-in-group (SIG) code 7 and 8 (maximum of two). If none, enter 0.
2nd and 3rd digits - Number of individuals with status-in-group Code 5 (maximum of nine). Always enter as two-digit number. If none, enter 00. If there are more than nine Code 5s, use Form H1008.

Note: See C-500 for additional codes and instructions to Form H1000-C. A Form H1000-C cannot be submitted without Form H1000-A or Form H1000-B.

Item 214: FIC (R/E) (Finger Image Code)

TANF and SNAP

Enter individual's finger image enrollment or exemption code.

Code or Action	Definition
Y	If all available images have been taken
Z	If one image has been taken
A	Appeal pending (TANF related)
B	Low quality image, physically unable to image or equipment failure
C	Certified out of office or unable to come to office
D	Undue burden for disabled individual
E	Undue burden for elderly individual
F	Disqualified (FS only)

D — Undue burden for disabled individual

E — Undue burden for elderly individual

F — Disqualified (FS only)

Item 215: LSIS Vendor's Unique Number (VUN)

TANF and SNAP

If the entry in Item 214 is Y or Z, enter the nine-digit VUN.

Item 216: Disqualification Type

SNAP

Enter the code(s) to indicate that an individual is being disqualified for one or more the following reasons.

Code or Action	Definition
B	ineligible alien without BCIS document
C	ineligible aliens with BCIS document
D	felony drug conviction
F	first offense failure to comply with ESP requirements (E&T, voluntary quit or reducing work hours to less than 30)
J	fugitive
N	failure to meet SSN requirement
S	second offense failure to comply with ESP requirements
T	third or subsequent offense failure to comply with ESP requirements
W	failure to comply with the 18-50 work requirement

Item 217: Remove

SNAP

Enter a code below to end a disqualification or change a time-limited benefit code.

Code or Action	Definition
1	delete the first countable month
2	delete the second countable month
3	delete the third countable month
4	delete the fourth countable month (first month of second three month period)
B	end the ineligible alien (undoc) disqualification
C	end the ineligible alien (doc) disqualification
F	end the first offense SNAP ESP disqualification
J	end the fugitive disqualification
L	subtract one offense from the ESP offense counter (when entering Code L, do not enter Code F, S, or T in Item 216 on the same Form H1000-A, Form H1000-B and Form H1000-C transaction)
N	end of the SSN disqualification
S	end the second offense SNAP ESP disqualification
T	end the third offense SNAP ESP disqualification
W	end the 18 - 50 work requirement disqualification

Items 218-223

SNAP

Make entries in these fields to report that HHSC has authorized a SNAP benefit for a countable month of the initial or second three-month period of time-limited benefits in a 36 month period for an individual age 18-50. Make entries of Code(s) 1-4 in Items 218 and the corresponding month(s) in Item 219.

Items 218, 220, and 222 – Countable Month Code

SNAP

Enter one of the following codes and a corresponding month in Item 219, 221, and 223:

Code or Action	Definition
1	benefit authorized for the first month of the initial three-month period
2	benefit authorized for the second month of the initial three-month period
3	benefit authorized for the third month of the initial three-month period
4	benefit authorized for the first month of the second three-month period

Additional Codes

TANF

Benefit History Codes

Code or Action	Definition
A	Mailed warrant or EBT benefit issued
C	Warrant held
D	Warrant or EBT issuance cancelled
E	Warrant charged back
P	Warrant paid by state treasure
R	Warrant returned
S	Warrant stop payment in effect
L	Warrant stop payment lifted
Y	Duplicate EBT benefit or warrant issued
Z	Duplicate warrant returned

Read benefit history codes on inquiry from right to left. The most recent code or action appears on the far left.