PM 03-06-05-c

Form 4691C tells the customer that to request an exception they are to complete the Request for Exception form and mail it to:

DHS Bureau of Policy Development
revised text100 South Grand Avenue East 
Springfield, IL 62762

When BPD receives Form 4691C, it is immediately date-stamped, logged in, and then faxed to the appropriate Family Community Resource Center.

revised textIf a customer submits Form 4691C to the Family Community Resource Center instead of to BPD, Family Community Resource Center staff date stamp the request and fax it to BPD at (217) 557-5850, or email it to dhs.policydevelopment@illinois.gov the same day.

When an applicant or active customer completes Form 4691 in the Family Community Resource Center, date stamp it and fax it to BPD at (217) 557-5850 the same day. Do not ask the customer to mail it to BPD.

Customers may file Form 4691 at any time. However, if a customer completes Form 4691 before any adult receiving or requesting TANF in their case has a counter of 57 or more, the request will be denied without considering whether the customer meets an exception reason. The customer must file a request again after the highest counter reaches 57.