PM 16-01-01.

Change in Caretaker Relative

If the new caretaker relative did not sign the original application, have the caretaker relative complete and sign a Form 243 or Form 2378B.

Complete Form 552 to change the caretaker relative:

  • Item 1 - Enter the new case number, or if the new payee previously received aid under the same category, enter the former case number.
  • Item 3 - Enter 14.
    • NOTE: If a canceled case is being reopened with a new payee, enter 12.
  • Items 8, 9, 10 - Enter the name and address of new caretaker relative/payee.
  • Item 28 - Complete when applicable.
  • Item 44 - Complete when applicable.
  • Item 46 - Line out any entry in this item.
  • Items 50-52 - Complete when applicable.
  • Items 60-74 - Complete if caretaker relative is included in the unit.
  • Item 75 - Enter the responsible relative or stepparent's SSN if they are in the home but not included in the unit. Enter the SSN of the person whose work history makes it likely they will become employed, increase earnings, or receive UI benefits.