DHS-8131-ENG (SNAP Quality Control Help Form)

DO YOU NEED AN INTERPRETER?

No

Yes

LANGUAGE

MAXIS Case Number - This is the case number used for your county or tribal nation SNAP or MFIP case

Quality Control Review Number - this number is listed on all Quality Control forms

REASON FOR CONTACT

Schedule or Reschedule an interview with a Quality Control Reviewer

Submit documents or verifications as requested by a Quality Control Reviewer

Please select all days and times that work best for you:

Monday 6am-12pm

Monday 12pm-6pm

Tuesday 6am-12pm

Tuesday 12pm-6pm

Wednesday 6am-12pm

Wednesday 12pm-6pm

Thursday 6am-12pm

Thursday 12pm-6pm

Other

PLEASE DESCRIBE

If these days/times don't work for you, a Quality Control Reviewer will contact you.

Attach supporting documentation

Additional information or details you'd like to provide: