Interview questions and statements for a DCF (Department of Children and Families) application interview for cash and food assistance in North Florida.
Disclosures
You are required to report if your household’s total gross monthly income exceeds 130% of the federal poverty level for your household size. This information must be recorded. You must also report if anyone in your household receives $4,500 or more at one time from lottery or gambling winnings.
Able-bodied adults without dependents are required to work or participate in qualifying work activities for at least 80 hours per month. You must report if your work hours fall below 80 in a month, unless it is due to one of the three exemptions just discussed. Is that understood?
You must report changes online using your My ACCESS account within 10 days after the change occurs. You must provide the agency with complete and correct verification of requested information within the time limit you are given.
You must also cooperate with child support enforcement. Additionally, you must report if anyone in your household will be away from home for 30 days or more, along with any other required changes.
You must report when your household’s gross monthly income exceeds 130% of the federal poverty level by the 10th day of the month following the change. If your household receives cash assistance or Medicaid, with or without food assistance, you must report changes within 10 days.
Adults without dependents are defined as individuals aged 18 to 64 who are physically and mentally fit for employment. These individuals must report when their hours of work fall below an average of 20 hours per week, or 80 hours per month.
You must cooperate with the state. Any person, including a designated or authorized representative, who provides false information, withholds information, pretends to be someone else, or commits fraud to obtain state or federal public assistance benefits is guilty of a crime and will be punished as allowed by law.
Any person who intentionally helps another person commit these acts is also guilty of a crime and subject to legal penalties.
We are required to protect the confidentiality of your health information, except in specific circumstances. We will use or disclose only the minimum information necessary. For some uses or disclosures, we must have your written authorization, which you may revoke at any time.
You have the right to request restrictions on how your information is used, to choose how we contact you, to inspect and copy your Protected Health Information (PHI), and to request an amendment to your PHI.
My signature on this application authorizes DCF and its partners to contact my current and past employers to verify the information I have provided. If any information I provide on this application or during any interview is incorrect, my benefits may be reduced or denied.
If I provide incorrect information intentionally, I may be subject to criminal prosecution or disqualification from receiving food assistance, cash assistance, or Medicaid.
I certify under penalty of perjury that the information in this application is true to the best of my knowledge. If you or any mandatory household member does not complete the work requirements, a penalty will be applied to your food assistance benefits.
Questions
- What country were you born in?
- Is the address and phone number correct on your application?
- Did you review your rights and responsibilities when applying for benefits?
- Is everyone in the home a US citizen?
- Do you have a bank account?
- Who do you bank with and what’s your account balance today?
- Is it a checking or savings account?
- And do you have a vehicle?
- What is the year, make and model of the vehicle?
- Do you have any earnings from lottery or gambling?
- Are you self-employed?
- Do you receive money from family and friends?
- Are you paying for water?
- How much are you paying?
- Do you pay for phone services?
- Do you pay trash removal?
- Are you running from the police?
- Can you report yourself as homeless?
- Are you or anyone else pregnant in the home?
- Are you planning to file taxes?
- Do you have any tax deductibles? This would be like Child Care deductions or any charitable donations.
- Will you claiming everyone in the household as a tax dependent?
- Will you be claiming a person outside the home as a tax dependent?
- If anyone in the home or college student?
- Did you receive foster care or medicaid?
- Do you have any third party insurance policies to report?
- Are you a registered voter?
- Do you want to register to vote? But are you unable to vote?
- Have you received food assistance, cash assistance or Medicaid in another state
- Have you been convicted of receiving benefits in more than one state at the same time?
- Have you been convicted of drug trafficking?
Closure
This was the end of this for today, once this information has been reviewed and processed, they will send you a notice by mail, letting you know if you are approved for the benefits or not.
You will receive a letter with a list of documents that you had to provide, you will have 10 days from today to provide those documents. You just have to turn in documents. Once everything has been reviewed, they’ll send you a notice letting you know if you’re approved.