Indiana notification form 2025

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SNAP Interim Contact. It is time for an Interim review of your Supplemental Nutrition Assistance Program (SNAP) eligibility. To determine if your household is eligible to continue receiving SNAP benefits, we need to know if there have been changes in your household situation. There is no need to conduct an interview.
WHAT IS THE SIGNIFICANCE OF THIS LAW? Indianas security breach notification statute, effective July 1, 2006, provides Indiana residents with the right to know when a security breach has resulted in the exposure of their personal information.
Establishing an Authorized Representative with the state The form needs to be signed by you and the person you authorize as your representative. It should then be filed with the state by fax to 888-436-9199 or delivered by mail or in person to your local county office.
Click here or call 800-403-0864 to report a change to your SNAP (food assistance), TANF (cash assistance) or Medicaid (health coverage) case; such as income, household member changes, home address, employment status, etc.
If you are unable to bring it to the office due to age, handicap, or lack of transportation and you are unable to appoint an authorized representative, State Form 40988 can be mailed to the FSSA Document Center, P.O. Box 1810, Marion, IN 46952 upon completion.
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Fax: 888-436-9199 or deliver or mail to your local county office. If you do not see the form you are searching for in the sections below, you can search the state forms library.

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