Each IEVS report consists of a Summary Listing and Individual Case Sheets.

With the exception of State Resource (IRS) and BENDEX Wage, all Case

Sheets are to be filed in the case record.

Each IEVS report contains an "Other Assistance" area. This area will list an indicator if the member is receiving or has applied for assistance for AFDC, Food Stamps, or Medicaid and/or the case number, category, and worker number for the other assistance. Valid codes may include:

AFDC - Member is in an open AFDC case

FS- Member is in an open Food Stamp case

MED - Member is in an open Medicaid case

IMAP - Member is in a pending AFDC or Medicaid application

FSAP - Member is in a pending Food Stamp application

The following reports are generated to the county office for program applicants as a result of computer matches with each of the IEVS sources. The report numbers listed are for the Summary Report and the Case Sheet Report.

Report

NumberReport Title & Content

**FS-1946BENDEX Changes for Food Stamp Applicants As of ______ For Benefit

FS-1947Month ______

Casehead Name

Case Number

Register Number

Category

Member Name (from WFAP)

Member SSN (from WFAP)

SSAClaim Number (SSN under which the member is receiving SSA benefits)

Payment Code:A - Adjusted SSA benefit

CP -Current payment of SSA to member listed

S -Suspension of SSA benefit

T -Termination of SSA benefit

Payment Amount

FS-1957 BENDEX Wage/Pension Report for Food Stamp Applicants FS-1958

Casehead Name

Case Number

Register Number

Member Name

Member SSN

Category

Employer/Payer Name & Address

Report

Number Report Title & Content

Wage/Pension Year (year in which wage or pension was earned/paid)

Wage/Pension Amount

Type:AG - Agricultural PE - Pension SE - Self-employment

FS-1950 BENDEX Error Report for Food Stamp Applicants FS-1951

Casehead Name

Case Number

Register Number (from WFAP)

Member Name

Member SSN

Category

SSA Claim Number (SSN under which member is receiving SSA benefit)

Member Date of Birth

BENDEX Error Message (message will instruct the county regarding Action to be taken to resolve the IEVS data)

FS-1974State Resource Information for Tax Year _______ For Food Stamp

FS-1986Applicants

Casehead Name

Register Number

Member Name

Member SSN

Category

Income Amount

Type (specific type of unearned income on file with IRS)

Payer Name

Payer Address

Payer Account Number (identifies entity such as a bank which reported the data to the IRS)

The county office must review IEVS information on each report in accordance with FSC 2600 and 2700 and reconcile the information with case record information. When the necessary action has been taken on the case, the county office will document the case regarding its findings. Refer to FSC 2610 and 2620 for time frames for clearing report information.