Get Dma-7057.pdf. Referral For Investigation - Info Dhhs State Nc

The Dma-7057 form is essential for referring an investigation related to suspected erroneous payments. This guide will provide you with clear, step-by-step instructions to help you fill out the form accurately and efficiently online.

Follow the steps to complete the form with ease.

1. Press the ‘Get Form’ button to access the Dma-7057 form and open it in your online editor.
2. Enter the referral details by filling in the appropriate date, case name, address, street/route number, phone number, city, state, and zip code. Make sure all fields are accurately completed.
3. Provide directions to the home of the person(s) involved by writing detailed instructions in the designated field.
4. List the person(s) referred for investigation. Include their name, age, sex, and race. If more entries are necessary, continue on the back of the form.
5. Identify the program(s) of suspected erroneous payment along with the corresponding case number.
6. Fill in the state ID number, social security number, and the amount related to the erroneous payment if applicable.
7. State the reason for the referral in the provided section.
8. Indicate the approximate length of the erroneous payment and specify whether this payment is ongoing by checking the appropriate box.
9. If applicable, check whether verification of the erroneous payment is included in the case file, and attach any necessary documents.
10. Record whether the erroneous payment has been discussed with the client, along with the interview date if it has.
11. Document the remarks or comments made by the applicant/recipient during the interview and note their observed reactions or attitudes.
12. Assess whether the applicant/recipient appears mentally competent and note any visible physical disabilities if any.
13. Describe how the erroneous payment came to light in the comments section.
14. Ensure the form is signed and dated by both the income maintenance caseworker and the eligibility supervisor.
15. After completing the form, save any changes made, then download, print, or share the Dma-7057.pdf as needed.

Complete and submit your Dma-7057 form online to streamline your referral process.