Skip to Content
Illinois
Department of Human Services
Michelle R.B. Saddler, Secretary
Search:
Menu
for
Customers
Alcoholism & Addiction
Cash
Child Care
Customer Service
Developmental Disabilities
Disability & Rehabilitation
Food
Health & Medical
Housing
Mental Health
Pregnancy & Parenting
Violence & Abuse
Youth Services
Services
by Division
for
Providers
Becoming a Provider
Centralized Repository Vault (CRV)
Contracts
Forms
FAQs
Grants
Licensure & Certification
Payments
Procurement
RFPs
Rules
Software
Training
Provider Information
by Division
about
DHS
Contacts
Events
Initiatives
News
Brochures
Forms
Reports
Publications
About DHS
by Division
Breadcrumb
DHS
about DHS
Publications
Manuals
Family & Community Services Manuals
Cash, SNAP, and Medical Manual
Workers' Action Guide Chapter Table of Contents
WAG 27: Authorization of Assistance Action (Form 552)
Table of Contents
Item 1- Cat., Family Community Resource Center, Group No., Basic Number
Item 2 - Effective Date
ITEM 3 - TYPE ACTION
Item 4 - Definer
Item 5 - Caseload
Item 6 - Approval
Item 7 - Transmittal
Item 8 - Name
Item 9 - Street
Item 10 - City, State, Zip Code
Item 11 - Other PA
Item 12 - Nation of Origin
Item 13 - Race
Item 14 - FS NCIT
Item 15 - SNAP
Item 16 - Prop
Item 17 - Vol Sponsor Agcy
Item 18 - Primary Spoken Language
Item 19 - Group Home, Including CILA
Item 20 - H.H. Arr
Item 21 - Lang. Ind.
Item 22 - No. Liv. Tog
Item 23 - No. SNAP Elig/Eat Tog
Item 24 - SNAP
Item 25 - No Mec ID Only
Item 26 - Reserved
Item 27 - M.E.C. Rest.
Item 28 - Case Class
Item 29 - SNAP Income
Item 30 - Redetermination Date
Item 31 - Last Opening
Item 32 - Case Certified
ITEM 33 - TYPE ACTION REASON
33-01 TANF
33-02 AABD
33-03 CGA
33-04 SNAP
Item 34 - 0 Grant Reason
Item 35 - Trans. From Other PA
Item 36 - Reporting
Item 37 - Matchable
Item 38 - Assistance Grant
Item 39 - Client Notice Code
Item 40 - Replacing Warrants
Item 41 - Ending Med. Elig. Date/Date of Death
Item 42 - Date Entered State Inst.
Item 43 - Schedule No.
Item 44 - Client Contact
Item 45 - Direct Delivery
Item 46 - DD Acct. No.
Item 47 - 49 - Reserved
Item 50 - Palcs ID Number
Item 51 - Caseworker ID Number
Item 52 - PAL Codes
Item 53 - Residence
Item 54 - 58 - Reserved
Item 59 - Tele
ITEM 60 - FIRST NAME (Person Data)
Item 61 - Birth Date
Item 62 - Relationship
Item 63 - Status of Parent
Item 64 - State Of
Item 65 - Last Ill. Residence
Item 66 - Sex
Item 67 - Marital Status
Item 68 - Activity
Item 69 - Match
Item 70 - Vet Status
Item 71 - Ed. Level
Item 72 - Work Exp.
Item 73 - WT Hel. Cond.
Item 74 - Citizenship
Item 75 - Social Security Number
Item 76 - Last Med. Determ Date
Item 77 - Last Beginning Med. Elig. Date
Item 78 - Type Benefit
Item 79 - TPL
ITEM 80 - NEEDS/ INFORMATIONAL
80-01 - TANF
80-02 - AABD
80-03 - CGA
80-04 - SNAP
Item 81 - DCFS Region Number
Item 82 - RRP Provider Name
Item 83 - RRP Provider Number
Item 84 - RRP End Date
Item 85
Item 86
Item 87-89 - Reserved
ITEM 90 - INCOME
ITEM 91 - ASSETS/RECOUP
Item 92 - Date Processing Total
Item 93 - Special Messages
Item 94 - IL LINK Acct. No.
Item 95 - Printout Number
Item 96 - Remarks
Related Links
27-33-00 Item 33: Type Action Reason
27-80-00 Item 80: Needs/Informational
Items 1-10
Items 11-32
Items 34-59
Items 60-79
Footer
State of Illinois
Accessibility
Privacy
Report Abuse/Neglect
Contact DHS
DHS Outlook Login