1. 06/08/11 15:04:17 Client Copy FMIZVAM1
DHS/TSS DIVISION
PO BOX 64965
ST. PAUL MN 55164-0965
June 08, 2011 02:21 PM
CASE NUMBER: xx
xx
PROD xx
--------------------------------------------------------------------------
IMPORTANT INFORMATION REGARDING THIS DOCUMENT:
* This information is available in other forms to people with
disabilities by calling your county worker, SARAH A. JOHNSON at
(651) 431-4133.
* For TTY/TDD users, contact your county worker through the Minnesota
Relay at 711 or (800) 627-3529. For the Speech-to-Speech Relay,
call (877) 627-3848.
* The back of this page lists your appeal rights and responsibilities.
--------------------------------------------------------------------------
FOOD SUPPORT NOTICE OF DECISION
Your Food Support case will be closed as of July 01, 2011 because:
Allowed utility costs changed from $28.00 to $0.00. (Auth:18,8)
There are no eligible members in your Food Support unit.
(Auth:14)
Members not eligible:
xx has an ineligible immigration status. (Auth:11)
You should use your EBT benefits within a year. After one year, we cancel
the food benefits.
-------------------------------------------------------------------------
***** IMPORTANT APPEAL RIGHTS! READ THIS NOW! *****
If you don't agree with the action taken on your case, you can appeal. To
keep your benefits until the appeal, you must appeal:
* Within 10 days or
* Before the first day of the month when the action takes place.
If you miss the 10 day deadline, you can appeal within 30 days from the
date you get this notice (90 days for Food Support), but your benefits
will not start again unless you win the appeal. To find out more, read
the back of the first page of this notice.
WORKER: xx TELEPHONE: xx

2. At the time we mailed this notice, the state did not have an approved budget.
If there is not state budget effective July 1, 2011, it is possible we will not be able to
continue the Minnesota Food Assistance Program after June 30, 2011, until such time as
a budget is enacted and as authorized by law.
Call your worker or visit www.dhs.state.mn.us if you need more information. You may
also call 800-657-3629 (outside the metro area) and 651-431-3540 (metro area) for
updates.