Follow these steps to use the ADM-92 form to request verification

1. From the FACS Toolbar, click the “Generate Forms” icon.
2. Select the “ADM-92” option, and click Generate Forms.
3. Click the “Select” button to select the appropriate household member to request verification from, and click OK.
4. Click in the check box beneath “PROVIDE PROOF OF ITEM(S) CHECKED ON THE BACK OF THIS FORM.”
5. Enter a date in the yellow selected box. The date must be 10 calendar days. The date of request is date zero – count from there.
6. Enter “SNAP” in the box beneath “YOUR BENEFITS/SERVICES.”
7. If you are requesting verification for an application, check the box next to “WILL BE DENIED,” and enter the application date in the “EFFECTIVE” box. Otherwise, check “WILL BE CLOSED” and enter the date of the next effective month.
8. Fill in the boxes requesting the worker’s name/email address, days in office, phone number, and fax number.
9. Check the boxes next to each item that you are requesting verification for, using the text boxes to provide additional instructions to the client. For example, the text box can be used to be more specific about dates, which household member the verification is requested for, etc.
10. Click the “OK” button.
11. Print the ADM-92 to mail or give to the client, and send a copy to imaging for the case record.