Get 04-170 Date 06-17-2004 To: From: County Welfare Director Supply Clerk / Forms Coordinator Forms

Filling out the 04-170 form, which addresses important updates regarding food stamp notices, is crucial for ensuring that individuals remain informed about their benefits. This guide provides clear guidance on each section of the form to aid users in completing it accurately.

Follow the steps to successfully complete the form.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Fill in the 'DATE' field with the appropriate date if it is not already populated. This date may reflect the form issuance or effective date.
3. In the 'FORM NUMBER AND TITLE' section, ensure that the correct form number (QR 377.2) and title (Food Stamp Notice of Expiration of Certification - Quarterly Reporting) are listed.
4. Select the appropriate options from the 'ORDER UNIT' section to indicate whether the form is a new or revised version, and check any relevant boxes regarding the form's status.
5. Fill in the information regarding 'DISPOSITION OF OLD SUPPLY.' This may include instructions to use old forms until exhausted or to destroy them.
6. Follow any special instructions provided within the 'FORMS DISPOSITION AND SPECIAL INSTRUCTIONS' section to ensure compliance with form usage.
7. Complete the additional required information such as district office or agency details as specified, ensuring all fields are filled out comprehensively.
8. Save any changes made to the form. Users can choose to download, print, or share the completed form as needed.

Complete your necessary documents online and ensure timely submissions.