WAG 18-04-12-a: FS Only (08) Cases via Form 552

• Item 2 -Enter the effective month and year.
• Item 3 -Enter TA 34.
• Item 4 -Enter 6.
• Items 22, 23 -Complete.
• Item 33 -Enter the correct TAR.
• Item 39 -Enter Client Notice Code (if required) to generate or the central notices and calculation sheet.
• Item 44 -Complete.
• Items 60-62, 66, 78 - Delete entries for deleted member(s).
• Item 80 -Enter any FS needs codes and amounts that require change or correction.
• Item 90 -Change or delete income codes, RINs, or amounts as necessary.
• Item 91 -Change or delete FS asset codes or amounts as necessary.

If the deleted member is the payee for the unit, see WAG 16-01-04.

If the deleted member(s) receives cash or medical, delete the payee's cross-reference case ID number from the member's Form 552. Reenter Item 78, Type of Benefit.

NOTE: To delete a single unit cash or medical case with FS, see WAG 25-07-11.