6000, Retention of Forms

Revision 17-1; Effective May 5, 2017

6100 Retention

Revision 17-1; Effective May 5, 2017

Retain copies of Form H1172, EBT Card, PIN and Data Entry Request, and Form H1175, Authorization for Administrative Terminal Application Action, that are filed in the case record according to the retention period of the program.

  • Supplemental Nutrition Assistance Program (SNAP) – three years from the month the form was originated.
  • TANF – four years from the month the form was originated.

Retain copies of:

  • Form H1172, EBT Card, PIN and Data Entry Request;
  • Form H1173, EBT Card Issuance and PIN Self-Selection/Issuance Log;
  • Form H1174, Inventory of EBT Cards/PIN Packets;
  • Form H1175, Authorization for Administrative Terminal Application Action;
  • Form H1177, Transmittal and Receipt for Controlled EBT Documents; and
  • the void/return log that is filed in an administrative record by local EBT issuance staff for three years from the date of signature.

Note: Retain Form H1177 or the regional log used for the daily transfer of Lone Star cards at least until the monthly Form H1174 is completed.

Retain the local/benefit office and regional office Administrative Terminal (EBTDS303-1 System Report) for three years from the date of reconciliation.

Retain the documentation on the weekly review of EBT reports from regional administrative offices for one year.

Retain EBT user request forms for three years from the date the EBT user leaves the EBT position.

6200 Archival and Destruction of EBT Records

Revision 17-1; Effective May 5, 2017

EBT records are stored at the HHS contracted records center for three years. The EBT site coordinator must  
contact the EBT regional coordinator or designee for information or instructions before EBT records are  
archived.

EBT records are those "administrative" records (that is, EBT security and accountability documentation)  
that local/benefit office EBT issuance staff keep, including regional and other administrative (non-delivery)  
office EBT records.

Store EBT records that are older than two years for a complete state fiscal year.

EBT records that were audited but less than three years old may also be stored for a complete state fiscal  
year.

Retain records at the local/benefit or regional office if an investigation or audit closure is pending.

Title acronym: SAH