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Records the name of the adult household member and the status outcome, including whether the initial determination was correct or required benefit-level changes among FREE, REDUCED-PRICE, and PAID. Tracks DV progress, letter notices and expected response timelines, changes effective dates, and includes signatures and dates for confirming and verifying officials, with reference ISBE 68-21 (8/26).",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/confirmation-review-and-verification-tracking-form-direct-verification-dv/535874/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/confirmation-review-and-verification-tracking-form-direct-verification-dv/535874.png","ImageObject",300,407,{"name":92,"@type":93},"Chumphorn","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-10-10",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"When is the Direct Verification (DV) completed and how is it used?","Question",{"text":112,"@type":113},"DV is completed for applications selected for verification prior to confirmation, and the DV report must be printed and maintained. Confirmation review results are reported on the Verification Summary Report.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What actions are taken if the initial determination is incorrect?",{"text":117,"@type":113},"If initial determination is incorrect, the status may need to change between FREE, REDUCED-PRICE, and PAID. The form specifies notice timing and requires continued verification to determine the correct benefit level.",{"name":119,"@type":110,"acceptedAnswer":120},"How does the form track non-response during verification?",{"text":121,"@type":113},"It records when the first verification letter is sent and the expected response window. If the household does not respond or responds incompletely by deadlines, it notes completion of the second notice and the final outcome.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},535874,1792204826,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},2336475401981,"https://ap-avatar.wpscdn.com/avatar/22000c94efd8d5204d?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786935347598174694","CONFIRMATION REVIEW AND VERIFICATION TRACKING FORM  \n100 North First Street, W-270 Springfield, Illinois 62777-0001  \nNUTRITION DEPARTMENT  \nDirect Verification Tracking  \n(For use prior to confirmation and only for applications selected for verification. )  \nName of Adult Household Member:    \nDirect Verification (DV) completed   (Date) . (The DV report MUST be printed and maintained. ) Verification of this application is complete and should be reported on the Verification Summary Report.  \nConfirmation Review  \n(Prior to verification and only for applications selected for verification. )  \nDate of Confirmation Review:    \nInitial determination was correct, continued with verification process.  \nInitial determination was incorrect, status MAY need to be changed from FREE to REDUCED-PRICE, continued with verification to determine correct benefit level.  \nInitial determination was incorrect, status needed to be changed from REDUCED-PRICE to FREE.  \n• Change of benefit level occurred/will occur on   (Date) . (Change must be within 3 days of confirmation review. )  \nInitial determination was incorrect, status needed to be changed from FREE or REDUCED-PRICE to PAID. Households must be given a 10 day notice of change.  \n• Change of benefit level occurred/will occur on   (Date) .  \nSignature of Confirming Official   Date    \nVerification Tracking  \nDV did not yield a match. Verification letter (First Request) was sent   (Date) .  \n• Response expected  (Recommend 10 calendar days from the date the letter was sent. ) Household did not respond to first request. Second notice completed   (Date) .  \n• Response expected   (Recommend 3 business days from the date the letter was sent. ) Household did not respond completely, OR household did not respond at all by deadline of second notice.  \n\n| Initial determination was: |  | Verification resulted in: |  | Reason for change: |  |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| | FREE based on SNAP/TANF case number\u003Cbr>FREE based on Income and Household Size\u003Cbr>REDUCED-PRICE based on Income and Household Size | | No Change\u003Cbr>FREE to REDUCED-PRICE\u003Cbr>FREE to PAID\u003Cbr>REDUCED-PRICE to FREE\u003Cbr>REDUCED-PRICE to PAID | | Income: $  |  |\n|  |  |  |  | | Household Size: Directly verified |  |\n|  |  |  |  | | Incomplete or no response Other:   |  |\n\nDate verification result was sent or notice of status change was made:    \n• Type of notice sent:  \nMail  \nPersonal Contact  \nTelephone  \nEffective date of status change (If applicable):   (Must be a minimum of 10 calendar days from the date notice of verification result was sent. )  \nSignature of Verifying Official   Date    \nISBE 68-21 (8/26)  Print   Reset Form","cbCaivaxwIOjaMaI","https://ap.wps.com/l/cbCaivaxwIOjaMaI","pdf",343488,"English","# Direct Verification Tracking\n## Confirmation Review\n## Verification Tracking\n## Verification Result and Notices","[{\"question\":\"When is the Direct Verification (DV) completed and how is it used?\",\"answer\":\"DV is completed for applications selected for verification prior to confirmation, and the DV report must be printed and maintained. Confirmation review results are reported on the Verification Summary Report.\"},{\"question\":\"What actions are taken if the initial determination is incorrect?\",\"answer\":\"If initial determination is incorrect, the status may need to change between FREE, REDUCED-PRICE, and PAID. The form specifies notice timing and requires continued verification to determine the correct benefit level.\"},{\"question\":\"How does the form track non-response during verification?\",\"answer\":\"It records when the first verification letter is sent and the expected response window. If the household does not respond or responds incompletely by deadlines, it notes completion of the second notice and the final outcome.\"}]","CONFIRMATION REVIEW AND VERIFICATION TRACKING FORM - Direct Verification (DV) | PDF",1791601278]