Food stamp recipients must fill out this form at the time of their application/recertification interview or when a household member leaves the home to attend boarding school or a treatment center.
The form is used to report that a household member is attending a boarding school or treatment center and to attest the person's monthly share of Temporary Assistance for Needy Families (TANF), Bureau of Indian Affairs (BIA) and Tribal Work Experience Program (TWEP) benefits will be spent on them.