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Effective Date: 



Updated: 10/2001


To provide households with a notice that the department plans to remove food stamp benefits in a dormant Lone Star food account to repay a food stamp claim.


When to Prepare

OIG or ARTS staff completes Form H1022 when a food stamp household requests a debit of a dormant Lone Star food account to repay a food stamp claim.

Number of Copies

Complete an original and two copies.


Original — Case Name
Copy — Lone Star Technology
Copy — OIG/ARTS office file


The case folder file is retained for three years or until the claim is repaid, whichever is greater.

Detailed Instructions

  1. Enter the case name and mailing address.
  2. Enter the date, food stamp case number, case name, office's name, and address and telephone number of staff completing theletter.
  3. Enter the amount to be deducted from the EBT account.
  4. Enter the amount of the outstanding balance of the food stamp claim.
  5. Enter the response due date for the household.