| State SNAP Agency NDNH Matching Program Performance Report |
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Federal Fiscal Year: |
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Quarter: |
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Amended: |
Y ( ) N ( ) |
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State: |
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1. |
2. |
3. |
4. |
| Match Type |
Quarter |
Month |
Unduplicated Individuals Verified as Employed |
Unduplicated SNAP Cases Closed Due to Earnings |
Unduplicated SNAP Cases with Benefits Reduced |
Unduplicated First-Month Avoided SNAP Costs |
| W-4 Data Match |
Quarter 1 |
Oct |
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| Nov |
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| Dec |
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| Quarter 2 |
Jan |
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| Feb |
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| Mar |
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| Quarter 3 |
Apr |
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| May |
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| Jun |
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| Quarter 4 |
Jul |
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| Aug |
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| Sep |
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| QW Data Match |
Quarter 1 |
Oct |
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| Quarter 2 |
Jan |
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| Quarter 3 |
Apr |
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| Quarter 4 |
Jul |
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| UI Data Match |
Quarter 1 |
Oct |
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| Quarter 2 |
Jan |
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| Quarter 3 |
Apr |
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| Quarter 4 |
Jul |
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Unduplicated
Annual Total |
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0 |
0 |
0 |
$- |
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| “Unduplicated” means counting the same person no more than once per federal fiscal year. Individuals should only be counted in one of the three data sources. |
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| Please see instructions below for an explanation of the four performance measures. |
| For detailed instructions, please see accompanying document: "Explanation and Detailed Instructions on How to Complete and Submit the State SNAP Agency NDNH Matching Program Performance Reporting Tool" |
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| General Instructions |
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| Report all outcomes in the month the match was conducted, not the month of state verification or case action. State agencies will report data by December 31, which is 90 days after the end of the federal fiscal year (October 1- September 30). |
| Previously Unknown Employment |
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| Item 1. |
Unduplicated Individuals Verified as Employed (receiving SNAP benefits): The number of unduplicated individuals with previously unknown employment that had an NDNH match and were verified as being employed while receiving SNAP benefits in your state. |
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| Actions Taken |
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| Item 2. |
Unduplicated SNAP Cases Closed Due to Earnings: The number of unduplicated individuals reported in item 1 whose SNAP benefits were terminated as a result of employment verified from an NDNH match. |
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| Item 3. |
Unduplicated SNAP Cases with Benefits Reduced: The number of unduplicated individuals reported in item 1 whose SNAP benefits were reduced as a result of employment verified from an NDNH match. |
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| Avoided Costs |
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| Item 4. |
Unduplicated First-Month Avoided SNAP Costs: The total first-month SNAP costs avoided from items 2 and 3. |
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| Unduplicated Annual Total |
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| The unduplicated annual total equals the sum of each column. The total for item 4 represents the annual unduplicated first-month avoided SNAP costs resulting from use of the NDNH. |
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