PM 01-01-04

revised manual textProviding Proof of Benefits Received to Customers

(FCRC) Complete Form 3711 in its entirety and with the most recent information for any customer requesting verification of their benefits. 

  1. When a customer asks for verification of their benefits, find out from the customer the names of all persons who should be included on Proof of Receipt of Program Benefits (Form 3711). Use the Integrated Eligibility System (IES) to verify eligibility for each individual. Do not give copies of IES screens to the customer to use as their proof of benefits.
  2. Complete Proof of Receipt of Program Benefits (Form 3711) in the following sections:
    1. Full name of the person;
    2. Enter (Yes) or (No) for the applicable program the person is receiving. Do not leave blank; and
    3. The current benefit receipt month; and
    4. Date benefit is approved; and
    5. Date benefit ends (or must be renewed).
  3. The IDHS employee completing the form should sign and complete the name and address in the FCRC section. Affix the Family Community Resource Center stamp to the form.  
  4. Upload a copy of the Form 3711 to the customer's electronic case file in IES.

Providing accurate information on Form 3711 is important as some customers may qualify for additional services with another agency or governmental department, if they can show proof that they are eligible for a DHS program or service.

Example: A customer who is applying for a fee waiver from the Department of Homeland Security - U. S. Citizenship and Immigration Services (USCIS) may be eligible for a waiver of fees related to various applications and petitions processed by USCIS. The waiver is requested using USCIS Form I-912. 

new manual textBureau of Customer Support and Services

(DHS helpline) Completes Form 2160, Verification of Public Assistance Income to verify income for the Illinois Housing Authority. This form should only be used by the DHS helpline staff.

Local, State, Federal Law Enforcement Officials

All requests for SNAP case information from local, state, or federal law enforcement officials must be in writing. The written request must contain:

  • the identity and legal authority of the person making the request;
  • the nature of the violation being investigated and its connection to the enforcement of the SNAP Program; and
  • the identity of the person for whom the information is being requested.
  1. (FCRC) Make an entry in the case record when any case information is released. Include:
    • the name of the person requesting the information;
    • the agency represented;
    • the date of request and the date of the release of information;
    • the specific information released; and
    • the reason for the release.
  2. (FCRC) Make an entry in the case record when any request for case information is denied. Explain the reason for denial.

Community Outreach Partners

A customer may complete an Outreach Partner Consent Form (IL 444-3690) allowing an outside agency to inquire about their application or case status, including help with providing verifications.

Form 3690 may be faxed, mailed or brought to the FCRC. Form 3690 is voluntary. Refusal to complete Form 3690 does not affect eligibility for SNAP outreach services provided by the Outreach Partner, or the customer's eligibility for benefits. This consent form is not valid more than 180 days beyond the date of signature.  Form 3690, does not give the outside agency permission to act as an approved representative for the customer (see PM 02-04-02-a).