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
XXXXXXXXXXXXXXXXXXXXXXXXXXXXX VEHICLE RESOURCE XXXXXXXXXXXXXXXXX
DATE SGCC WORKED CASE: 11/3/2006 2:09:43 PM
METHOD OF CONTACT ( )PHONE ( )FAX ( )MAIL ( )OTHER
CONTACT'S NAME/SOURCE:
VEHICLE YEAR,MAKE AND MODEL:
VEHICLE USED TO TRASPORT DISABLED/INCAPACITATED AU MEMBER:
OWNED/LEASED VEHICLE:
JOINT OWNERSHIP ( )YES ( )NO JOINT OWNER'S NAME:
# OF VEHICLES IN AU:
FMV: VERIF SOURCE USED FOR FMV:
AMOUNT OWED:
CALCULATION OF VEHICLE RES[1ST VEHICLE] FMV-$4650:
*****ALL OTHER VEHICLES,COUNT EV[FMV-AMT OWED]:
VEHICLE EXCLUDED ( )YES ( )NO
INCLUDED IN BANKRUPTCY ( )YES ( )NO EXPLAIN:
TYPE OF VERIFICATION:
Form C173 Sent: Due Date:
Remarks:
Enter Name, Load and Tel #
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
PM-41