14 DC Exhibit 5. SNAP Integrated Application

Illegal Use of Benefits and Penalties
The District of Columbia may pursue criminal charges against you and seek to disqualify you from receiving public
assistance in the future if you break the public assistance program laws.
You must not:
• Allow someone else to use your Medicaid card/benefits;
• Continue to use your Medicaid card/benefits if no longer a resident of DC;
• Accept payment from a provider in return for receiving Medicaid covered services, unless authorized as part of an
approved Department of Health Care Finance (DHCF) program;
• Give false information or withhold information to get or continue to get benefits;
• Engage in SNAP Trafficking including trading or selling SNAP benefits, or electronic benefit transfer (EBT) cards;
• Use SNAP to buy items not allowed, such as alcohol, drugs, and firearms, or for paying on credit accounts;
• Allow a person who is not approved as an authorized representative or nominee to use your EBT PIN (personal
identification number);
• Use someone else’s benefits;
• Use someone else’s EBT Card without authorization; or,
• Use your EBT card containing TANF benefits in a liquor store, adult entertainment venue, such as a strip club or in a
gambling establishment such as a casino.
Your SNAP benefits will not increase if your cash assistance is reduced or closed because you did not follow the rules. If a household
member commits an Intentional Program Violation (IPV), which means deliberately breaks the rules;
• DHS may disqualify the person from the benefit programs.
• DHS may disqualify this person for 6 months for the first violation (TANF and Program on Work Employment and
Responsibility (POWER)).
• DHS may disqualify this person for 12 months for the first violation (SNAP) or second violation (TANF and POWER).
• DHS may disqualify this person for 24 months, for the second violation (SNAP) or after the first time a court finds this
person guilty of buying illegal drugs with SNAP benefits.
• DHS may disqualify this person from participating in benefits programs permanently:
• After the third violation (TANF, POWER, and SNAP), or
• After the second time a court finds a person guilty of buying illegal drugs with SNAP benefits, or
• After the first time a court finds this person guilty of buying guns, bullets, or explosives, with SNAP benefits, or
• After a court finds this person guilty of trafficking SNAP benefits of $500 or more.
DHS may disqualify a person who commits an Intentional Program Violation from participating in benefits programs permanently
DHS may disqualify this person for ten years if found guilty of making a false statement about the person’s identity or residence in
order to receive multiple benefits at the same time.
Any member who breaks any of the rules on purpose can be barred from the SNAP program for one year to permanently, fined
up to $250,000, imprisoned up to 20 years, or both.
A judge can also disqualify this person from receiving TANF and/or SNAP benefits for an additional 18 months. The person may
also have to face further prosecution under other federal laws. Individuals who request four (4) or more replacement EBT cards in
one year may be referred to the District of Columbia Office of the Inspector General for investigation of trafficking benefits.
I attest and declare under penalty of perjury to the best of my knowledge and belief that the information submitted is
correct and the person(s) for whom I am applying for benefits is/are U.S. citizen(s) or are lawfully present in the United
States.

Sign here

Date

Applicant or Representative Signature

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