A CA EBT Out of State Usage - Reapplication After Closure
 
(01/01/20 - 12/31/20)
A participant may reapply on or after the effective date of their CA closure. When the closure is due to failure to comply with the EBT Card Out Of State Usage requirements, complete the following during the interview:
 
Review the EBT Transaction History.
Complete the EBT Card Out of State CA Usage Questionnaire (FAA 1596A) form.
Discuss and document the FAA-1596A with the reason for the participant spending their benefits out of state.
Document CADO with a summary of the discussion.
Upload or scan the completed form to OnBase(g) as Document Type Group <All> and Document Type, FAA1596AFORFF EBT CARD OUT OF STATE USAGE QUESTIONNAIRE.
Send the completed questionnaire via email to the Research and Analysis (R&A) Unit at [email protected].
Complete the CA approval when the following apply:
Eligibility factors have been met and verified
An NQ or RQ code is keyed in the EBT OUT OF STATE RESULT field on INDA