5 PA Exhibit 5. SNAP Application

Generic Clearance for Questionnaire Pretesting Research

Exhibit 5. SNAP Application

OMB: 0607-0725

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Prohibitions and Penalties

Read about your responsibilities:

IF THIS HAPPENS WITHOUT GOOD CAUSE
Misuse Electronic Benefits Transfer (EBT) Card or PA ACCESS Card.

Fine, prison, or both.

Do not report changes, as required.

Benefits cut or stopped.
Fine, disqualification and/or jail time for Welfare Fraud,
disqualification for administrative hearing proceedings.

ALL BENEFITS
SNAP
CASH

On purpose, give information that is false, incorrect or incomplete, or not report changes.

MEDICAL
ASSISTANCE

On purpose, misuse SNAP benefits, for example, trade, sell, or buy EBT Card or SNAP benefits;
convert benefits; or dump containers purchased with SNAP benefits to receive deposits – or
buy things not covered by SNAP, such as alcohol or tobacco – or use SNAP benefits to pay for
food already received or food on credit.
Purchase a product with SNAP benefits with the intent of obtaining cash or consideration
other than eligible food by reselling the product in exchange for cash or consideration other
than eligible food.

CASH

Not eligible:
•	 First time - 12 months.
•	 Second time - 24 months.
•	 Third time - forever.
•	 First time court conviction over $500 - forever.

Use/receive SNAP benefits to buy drugs or controlled substances.

Not eligible:
•	 First time - 24 months.
•	 Second time - forever.

Use/receive SNAP benefits in sale of firearms, ammunition, or explosives.

First time - not eligible forever.

Be convicted for buying, selling or trading SNAP benefits for total of $500 or more.

Not eligible forever.

Lie about who you are or where you live to receive more than one SNAP benefit.

Not eligible for 10 years.

Flee to avoid prosecution, custody, or confinement because of a felony/attempted felony – or
flee because of breaking probation or parole.

Not eligible until you do what the law says.

Do not comply with your court penalty, including payment of fines, for a felony or misdemeanor.

Not eligible until you comply with your penalty.

Lie about where you live to receive cash in two or more states.

Not eligible for 10 years.

Flee to avoid prosecution, custody, or confinement because of a felony conviction/attempted
felony; fail to appear as a defendant at a criminal court proceeding when issued a summons
or a bench warrant for a summary offense, felony or misdemeanor; flee because of breaking
probation/parole; or have any active warrant against you.

Not eligible until you do what the law says.

For household members – physically and mentally fit – over age 15 and under 60 – not
otherwise exempt or with good cause.

CASH
WORK
RULES

Not eligible:
•	 All court convictions - 12 months.

On purpose, purchase products originally purchased with SNAP benefits in exchange for cash
or consideration other than eligible food.

If you are found guilty of fraud or breaking the above rules:

SNAP
WORK
RULES

Not eligible for cash:
•	 First time - 6 months.
•	 Second time - 12 months.
•	 Third time - forever.
Not eligible for SNAP:
•	 First time - 12 months.
•	 Second time - 24 months.
•	 Third time - forever.

Trade, sell or attempt to trade, sell, buy or use another person’s ACCESS Card.

SNAP

THIS MAY HAPPEN (PENALTY)

Refuse to:
•	 Accept a job.
•	 Tell CAO about work status and job availability.

Do not meet cash work requirements on
purpose, as written on the Agreement of Mutual
Responsibility (AMR).

On purpose, take action to:
•	 Quit a job.
•	 Cut work hours to less than 30 per
week (unless another job already
meets work requirements).

•	 Fine up to $250,000 for SNAP and up to $15,000 for Cash;
•	 Jail up to 20 years for SNAP and up to seven years for
Cash; and/or
•	 Paying back benefits received.
•	 Disqualification from benefits for periods stated above by
program.
Not eligible:
•	 First time - one month and until you do what is required.
•	 Second time - three months and until you do what is required.
•	 Three or more times - six months each time and until you
do what is required.

Not eligible:
•	 First violation - You will be ineligible for a minimum of 30 days or until the failure to comply ceases,
whichever is longer.
•	 Second violation - You will be ineligible for a minimum of 60 days or until the failure to comply
ceases, whichever is longer.
•	 Third violation - You will be permanently disqualified.
If the reason for sanction occurs within the first 24 months of receipt of cash assistance, whether
consecutive or interrupted, the sanction applies only to the individual.
If the reason for sanction occurs after 24 months of receipt of cash assistance, whether consecutive or
interrupted, the sanction applies to the entire family.

PA 600 2/20

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