(A)To initiate an administrative disqualification hearing, the local agency shall complete and submit a JFS 04060 "Referral for Administrative Disqualification Hearing" (rev. 1/2015 5/2001) or its computer-generated equivalent, to the bureau of state hearings.

(B)The JFS 04060 shall be accompanied by all information and documentation relied upon by the local agency in reaching its conclusion that an intentional program violation has been committed.

(C)If more than one assistance group member is suspected of committing an intentional program violation, a separate JFS 04060 shall be completed for each.

(D)If an individual is suspected of an intentional program violation in more than one program, a separate JFS 04060 shall be completed for each.

Effective: 3/1/2019

Five Year Review (FYR) Dates: 11/27/2018 and 03/01/2024

Certification: CERTIFIED ELECTRONICALLY

Date: 02/05/2019

Promulgated Under: 119.03

Statutory Authority: 5101.35

Rule Amplifies: 5101.35

Prior Effective Dates: 06/20/1980, 10/01/1981, 05/01/1982, 08/01/1983, 09/01/1994, 02/01/1995, 06/01/2003, 09/01/2008, 02/28/2014