Complete Form 552 as follows:

  • Item 2 - Enter a 4-digit date for the current processing month. For example, enter 10/96 if submitting the action effective for October 1996.
  • Item 3 - Enter TA 34.
  • Items 5 & 6 - Complete.
  • Items 8-21 - Complete as required.
  • Items 22-23 - Update when necessary.
  • Item 44 - Complete.
  • Items 60-70 - Complete. In Item 60, enter the RIN of the child(ren) being added to the benefit unit before the child's SSN, if the child previously had been assigned an RIN.
  • Do not require the completion of Form 3168, or enrollment in the EAB program, or ask the client to go to the SSA office before adding the newborn. The completion and delivery of Form 3168 to the SSA office or enrollment in the EAB program as a part of the TANF request meets FS requirements.
  • Item 77 - Enter a 6-digit date for the effective month, day and year that identifies the beginning medical eligibility approval.
  • Item 78 - When necessary, enter Code 3 to identify a newborn's eligibility for medical for up to one year from birth, see PM 18-03-00 and WAG 18-03-00.
  • Enter code C, G, or H to identify a child born while the benefit unit received TANF Cash at the time of the child's birth or conception, and the unit was not eligible for an increase in the Payment Level.
  • Item 80 - Use this item to enter spenddown codes and abbreviations, if applicable.
  • If, as a result of the addition, spenddown is created or met, follow WAG 18-05-00, Change in Medical Program Status. If spenddown is met for one month, see WAG 15-08-10.
  • Item 90 - Enter nonexempt income, if added or changed.
  • Item 91 - Complete, as needed.