C-540, Code Summary

Revision 08-4; Effective October 1, 2008


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


2 — TANF

5 — Refugee Cash Assistance (RCA)


6 — Public Assistance (PA) SNAP Case

8 — Refugee, PA SNAP

9 — Non-PA SNAP Case

ITEM 03: Sequence No. (SEQ)


Y — Yes

Item 27: Modifier (M)


P — Protective Payee

R — Representative Payee


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/group living arrangement facility.

ITEM 28: Indicator Code


M — Incapacity


U — (system entered when TP 61 transfers to TP 07, 20 or 37)


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


2 — Check for an existing number.

ITEM 35: Sex


M — Male

F — Female

ITEM 36: Race


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/Service Code


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/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


Primary Codes

2 — Disqualified/ineligible child or second parent

3 — Noncertified child: Identifies the only deprived child of the certified caretaker/second parent

If the child receives ...then enter SIG Code
Foster Care Payments3F
Adoption Assistance payments3A

5 — Certified Child

7 — Second Parent

8 — Caretaker

9 — Payee

0 — Case Name Only:

Secondary Codes

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


Head of Household Codes

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

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


AChild (SIG 5 or 5L)
BCaretaker or second parent, age 18 or younger attending school
CCaring for an ill or disabled child in the household, even if the child is not a member of the certified group
EUnable to work due to a disability expected to last more than 180 days
F60 years of age or older
GCaring for a child (SIG 2, 3, or 5) under age 1
HPresence required in home due to illness or incapacity of another adult household member and the disability is expected to last more than 180 days
JNot subject to participation – not a certified TANF individual
KPending during appeal of denial or disqualification
LCounty Hardship Exemption
MMandatory registrant
NEmployment Hardship Exemptions
PMandatory registrant employed or self-employed 30 or more hours per week and earning at least $700 a month
QSevere Personal Hardship Exemption
RCaring for child under age 1 who is not listed on Form H1000-A, Form H1000-B and Form H1000-C
TPregnant and unable to work
UA single grandparent age 50 or over caring for a child under age three
VAn SSI recipient parent.
WIdentifies a individual who noncomplies with the Choices program
XA parent who has exhausted state time limits.
YA 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.


AChild 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
DThree to nine-months pregnant
EPhysically or mentally unfit for employment
F60 years of age or older
GCaring for a child under age six
HPresence in home required for care of an incapacitated person
JPerson in drug addiction or alcoholic treatment and rehabilitation program
NReceiving or applying for unemployment compensation
PEmployed or self-employed 30 hours or more a week
QIndividual resides in a Choices county and is mandatory or has volunteered for TANF employment services
RRegistered again, after previously serving the E&T noncompliance penalty period
SStudent exemption (age 18 or older/in a training program)
TDisqualified household member or nonmember head of household
UPrimary wage earner failed to comply with SNAP employment services
2Registered, employed less than 30 hours a week
3Registered, not working
4Registered, job attached (temporarily laid off)
5Registration postponed, expedited service

ITEM 42A: Type Income


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)


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


The following format is used for all error messages: AAABBCCC

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:


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

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

Error Codes

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


C — Complete review

I — Incomplete review

N — Non-review activity (case maintenance)

ITEM 79: Application Codes


First Digit – Application Type1 – Eligibility Determination
2 – Redetermination
3 — Application reopened after denial
Second digitEnter X
Third digit – Number of Months0 – 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.



1 — NPA Only

2 — NPA Mixed


5 — Refugee, PA

ITEM 85: Test (Income Test/Shelter Deduction Identifier)


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)


A — Attendant

B — Boarders

C — Ineligible alien

D — Ineligible student

E — Any combination of two or more of A, B, C, or D



X — Every household member receives SSI

ITEM 90: Util (Utility Expense Code)


1Household claiming the Standard Utility Allowance.
2Household claiming telephone standard only, or telephone standard plus actual utilities.
3Household claiming actual utility costs only (even if some members are disqualified).
4Household without utility costs.
5Two households live together and share the standard utility allowance.
6Households claiming the standard utility allowance with member(s) disqualified for not meeting the citizenship, 18-50 work, and and/or SSN requirements.
7All 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).
8Household claiming the homeless shelter standard
9Household claiming the homeless shelter standard with one member who is disqualified for not meeting the citizenship, 18-50 work and/or SSN requirements
AHouseholds claiming the basic utility allowance.
BTwo households live together and share the basic utility allowance.
CHouseholds claiming the basic utility allowance with member(s) disqualified for not meeting the citizenship, 18-50 work, and/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


See C-221, Denial Codes.

ITEM 95: Code/Hold Date


Hold Codes

2 — Hold benefits

A — Form H1000-B has fatal error not cleared by cutoff

Z — Dormant EBT account (state office use)

Release Codes

0 — Do not hold future benefits.

ITEM 101: Prepared Meals Services Code


C — SSI/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/contracted restaurants)

H — Authorized to purchase from homeless meal providers/contracted restaurants

M — Household/disabled member authorized to purchase from meal delivery services

ITEM 104: Special Review Code


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

0 — State office assigned

1 — Employment Services/Work Registration

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

ITEM 127 Type Program


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


C — Complete review

I — Incomplete review

N — Non-review activity (case maintenance)

ITEM 132: Action Code


See C-200 for Item 132 Codes.

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


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



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)



Advisor Hold Codes

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

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

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


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


1 — Full months amount

2 — Additional amount for a month; Form H1000-B use only


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


Reason for authorization of benefits

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 and/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)


Full Regular Ongoing Benefits or Their Replacements

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

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 and/or D.

P — Restore an erroneously expunged EBT benefit.

Destroyed Food

T — Replacement of destroyed food, which was purchased with SNAP benefits

Advisor enter cancellation

G — Use to cancel EBT benefit because the household has moved out of state

ITEM 186: OTHER DATA (Range Code)


P — Initial month benefit prorated

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

Range CodeIssuance Dollar AmountRange CodeIssuance Dollar Amount
A1 - 49H350 - 399
B50 - 99J400 - 449
C100 - 149K450 - 499
D150 - 199L500 - 549
E200 - 249M550 - 599
F250 - 299X600 or over
G300 - 349-

ITEM 187: Household Composition for Benefit Requested


1st digitNumber of individuals with status-in-group (SIG) code 7 and 8 (maximum of two). If none, enter 0.
2nd and 3rd digitsNumber 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)


Enter individual's finger image enrollment or exemption code

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/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)

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


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

ITEM 216: Disqualification Type


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

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/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


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

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


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


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

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


Benefit History Codes

A — Mailed warrant/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/action appears on the far left.