Customer Contact Center Food Stamp/Family Medicaid Phase II ...

Call Center FS/FM SUCCESS PG October 24, 2007
Documentation MACROS/Quick Scripts
UPDATE REMARKS - REMA REMA
XXXXXXXXXXXXXXXXXXXCHANGE IN EMPLOYER XXXXXXXXXXXXXXXXXXXXXXXXXXXX
DATE SGCC WORKED CASE: 11/3/2006 12:51:04 PM
METHOD OF CONTACT ( )PHONE ( )FAX ( )MAIL ( )OTHER
CONTACT'S NAME/SOURCE:
PERSON WORKING: EFFECTIVE DATE:
*******PREVIOUS EMPLOYER'S NAME:
LAST DAY OF WORK: DATE AND AMOUNT OF FINAL CHECK:
REASON NO LONGER WORKING
HOW VERIFIED:
*******NEW EMPLOYER'S NAME: START DATE:
EMPLOYER'S ADDRESS/PHONE NUMBER:
HOURS WORKED/WEEK: RATE OF PAY: FREQUENCY OF PAY:
DAY OF WEEK PAID: DATE FIRST CHECK RECEIVED:
DOES A/R HAVE INSURANCE: DOES A/R PAY CHILDCARE:
CALCULATION OF PAY:
DOES A/R RECEIVE UCB/WORKERS COMP/CONTRIBUTION:
**** UPDATE WORK CODE IF NECESSARY***SEE MISC REMARKS FOR MANAGEMENT ****
TYPE OF VERIFICATION:
FORMS SENT( )C173 ( )C178 ( )C809 DUE DATE:
REMARKS:
ENTER NAME, LOAD AND TEL #
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