PM 02-05-01
If a walk-in applicant does not wish to give information for screening, issue Form 2378B. Tell the applicant that help is available in completing the application form.
If someone other than the person requesting benefits comes in to complete the application, they must have a written statement from the applicant (see PM 02-04-02-a and WAG 02-04-02-a).
If a paper application form is completed in the office, help the client if requested. If intake staff help complete the application form, write this on the application form.
An applicant may take the Form 2378B home and have relatives or friends help.
Complete Form 2378B for a home intake application when a person is physically unable to come to the Family Community Resource Center and they have no one available to act as an approved representative.
