WAG 26-06-01: TANF/FS Eligibility, Central Notice and Grant Information (Form 2943)

TANF/Food Stamp Eligibility, Central Notice and Grant Computation Information (Form 2943), must be completed and submitted along with Form 552 for any TANF Cash and/or TANF Cash/Food Stamp case that uses prospective eligibility and budgeting and is processed through IPACS.

The purpose of Form 2943 is to provide the central budgeting system with information that is not on Form 552 but is needed by the system to complete TANF and Food Stamp eligibility determinations and/or to send the correct notice and calculation forms to the client.

The system uses information on Form 2943 along with information on Form 552 for the following calculations:

  • prospective comparison to the Payment Level,
  • computing the cash benefit amount,
  • computing the central recoupment, and
  • determining prospective eligibility for food stamps.


Form 2943 is required on many Form 552 transactions that include, but are not limited to:

  • approvals processed through IPACS;
  • reinstatements;
  • resumptions;
  • cancellations for financial reasons;
  • Food Stamp approvals, FS REDEs or changes in food stamp entries on Form 552;
  • deleting a TANF unit member or component food stamp member;
  • adding a unit member when the case includes food stamps;
  • adding, deleting or changing income or needs;
  • changing case number, category or payee;
  • intra-office transfers when needs or income are entered;
  • SWAPS from Medical to Cash;
  • SWAPS from Cash to Medical due to receipt of a lump sum; and
  • recoupment actions if prospective information is changing.

NOTE: When prospective income information shown on ACID Screen 5 is incorrect, complete Form 2943 and submit along with Form 552 before entering an overpayment referral.


Form 2943 is not required with Form 552 when no change in income, needs, or food stamp entries are made. This includes but is not limited to:

  • address changes when food stamp entries are not changed;
  • additions to a TANF unit when the case is not receiving food stamps;
  • changes in case information that do not cause a reduction in income or needs (i.e., Items 61 through 79);
  • clearing a PAL code when no changes in income, needs or food stamp entries occur;
  • completing a REDE when no changes in income, needs or food stamp entries occur;
  • changing a caseload number;
  • suspensions.

When the only reason for completing a Form 2943 is to enter a zero dollar amount in Item 6, Other Unearned Income, Section A, TANF Grant Computation, enter $0 in the "Remarks" box of Form 552.