When Used: Use in place of the F827
Special Instructions: Use the V808; do not send the F827
This is to inform you that *NAME OF DISQUALIFIED INDIVIDUAL* is being disqualified from the Food Assistance program effective *MM/DD/YYYY*. The reason:
*Copy and Paste the applicable reason*
☐ This person has been found guilty of committing fraud by a court of appropriate jurisdiction.
☐ This person has signed a Food Assistance disqualification consent agreement.
Since this is the *NUMBER OF DISQUALIFICATIONS* violation, *NAME OF DISQUALIFIED INDIVIDUAL* will be ineligible to receive Food Assistance for *NUMBER OF MONTHS* from *MM/DD/YYYY to MM/DD/YYYY of disqualification period*.
The Department for Children and Families is owed $*OVERPAYMENT AMOUNT* as a result of this overpayment.
If the individual named above has not already signed a repayment agreement, one will be sent separately which must be completed and returned.
This action is based on Kansas Economic and Employment Services Manual Sections.
Esto es para informarle que *NAME OF DISQUALIFIED INDIVIDUAL* queda inhabilitado para el Programa de Asistencia Alimentaria a partir del *MM/DD/YYYY*. El motivo:
☐ Un tribunal con competencia jurisdiccional encontró a esta persona culpable de cometer un fraude.
☐ Esta persona firmó un acuerdo de consentimiento de inhabilitación para recibir Asistencia Alimentaria.
Debido a que esta es la infracción *NUMBER OF DISQUALIFICATIONS*, *NAME OF DISQUALIFIED INDIVIDUAL* no será elegible para recibir Asistencia Alimentaria por *NUMBER OF MONTHS* desde *MM/DD/YYYY to MM/DD/YYYY.
Se le adeuda al Departamento para los Niños y las Familias $ *OVERPAYMENT AMOUNT* como consecuencia de este sobrepago.
Si el individuo nombrado arriba no ha firmado ya un acuerdo de devolución, se enviará uno por separado, que deberá ser completado y enviado de regreso.
Esta medida se basa en secciones del Manual de Servicios Económicos y de Empleo de Kansas.