OKDHS Clients Have These Responsibilities:

I Agree

• let DHS give information about me to other government agencies or private organizations to get help for me
• let DHS make any necessary investigation or request to verify the information I give
• provide the documents necessary to establish my eligibility
• notify the local DHS office of changes in income or assets, such as vehicles, bank accounts, and property, people moving into or out of my household, address, shelter and utility costs, need for child care, or the child care provider I am using
• cooperate with the Office of Inspector General and/or the SNAP Quality Control Unit when asked to do so to determine my initial and continuing eligibility for benefits or in the audit or investigation of any child care facility my child attends

I understand:

• DHS has the right to deny the application if I give false information in order to get benefits
• criminal charges can be filed against anyone who knows they are giving false information to get benefits from DHS
• DHS uses the Social Security numbers (SSNs) of persons included in the benefits to match income data from other government agencies, such as the Social Security Administration, Internal Revenue Service, Oklahoma Employment Security Commission, and data brokers to help determine my eligibility for assistance
• I am certifying under penalty of perjury that every person in my household for whom I am applying for benefits is a United States citizen or an alien in lawful immigration status. I understand I must advise DHS of the immigration status of any person applying for benefits even if that person is not in lawful immigration status and is applying only for emergency medical services
• if DHS approves my household for benefits and it is later determined that I made a false claim of U.S. citizenship or lawful immigration status for anyone in my household, DHS files a complaint with the U.S. Attorney, and I may be subject to criminal prosecution
• information provided on this application is verified by federal, state, and local officials and information obtained through these sources could affect my eligibility and benefits,
• I will be responsible to pay any established overpayment
• I understand that I may not use my cash benefit card at any liquor store, gambling casino or gaming establishment, or retail establishment that provides adult-oriented entertainment in which performers disrobe or perform in an un-clothed state or whose principal business is that of selling cigarettes, cigar, or tobacco products.