[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-285383-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-285383-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","pennsylvania-department-of-human-services-community-service-volunteer-verification-form","Pennsylvania Department of Human Services - Community Service Volunteer Verification Form","","This Community Service Volunteer Verification Form is an official document provided by the Pennsylvania Department of Human Services. It is specifically designed to certify that individuals participating in SNAP-related community service meet the necessary work requirements defined by the County Assistance Office (CAO). The form serves as a critical reporting tool for organizations and agencies to verify volunteer hours, ensure compliance with SNAP ABAWD regulations, and facilitate timely communication between the service provider and the Department of Human Services regarding any changes in participation status. By documenting the volunteer's engagement and requiring validation from a site manager, the form ensures accountability in the administration of public human service assistance programs. It provides structured sections for agency and volunteer details, activity descriptions, monthly schedules, and formal certification by the supervising entity.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/pennsylvania-department-of-human-services-community-service-volunteer-verification-form/285383/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/pennsylvania-department-of-human-services-community-service-volunteer-verification-form/285383.png","ImageObject",442,249,{"name":42,"@type":43},"Oliver Hayes","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-17",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Who is authorized to sign this verification form?","Question",{"text":63,"@type":64},"The form must be signed by the site manager or supervisor who can officially attest to the volunteer's community service agreement and participation hours.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What is the purpose of this form in relation to SNAP benefits?",{"text":68,"@type":64},"This form is used to document community service hours for individuals subject to Able Bodied Adult Without Dependents (ABAWD) work requirements, helping them maintain their eligibility for time-limited Supplemental Nutrition Assistance Program (SNAP) benefits.",{"name":70,"@type":61,"acceptedAnswer":71},"What is the required procedure if a volunteer stops participating or fails to meet required hours?",{"text":72,"@type":64},"The agency must report such changes to the Pennsylvania Department of Human Services within 10 days of the date the change occurred using Section IV of the form.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},285383,1790556621,{"code":4,"msg":82,"data":83},"success",[84,88,93,98,103,108,112,117,122],{"id":55,"doc_module":22,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Presentations",90,"presentations",{"id":89,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},12,"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":110,"slug":111},17,40,"forms",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},18,"Letters",30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":82,"data":127},{"doc_id":79,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":109,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":139,"read_time":22},687207020761,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Community Service | Volunteer Verification Form Instructions  \nAn individual who is participating in the required number of hours determined by the County Assistance Office (CAO) may be considered meeting the Able Bodied Adult Without Dependents (ABAWD) work requirement and therefore not subject to time-limited Supplemental Nutrition Assistance Program (SNAP, food stamps) benefits.  \nThis form is used to document community service participation for up to six months of participation at a time.  \nIf the individual stops participating or participation falls below the required monthly hours of participation indicated by the CAO or Employment and Training (E&T) contractor, the agency must report this change to the Department of Human Services within 10 days from the date the change occurred.  \nWho may complete the form: The form may be completed only by an organization or agency that is providing a community service opportunity  \nto the applicant or recipient. Note: The Required Monthly Hours section is completed by the CAO or E&T contractor based on the hours computed by the CAO and listed on the Employment Development Plan.  \nWho signs the form: Only the site manager (or supervisor) who can attest to the community service agreement may sign the form.  \nGeneral form completion requirements: The information on the form must be complete and legible.  \nA signature by the site manager (or supervisor) is required.  \nReporting changes: Complete Section IV and fax or mail to:  \nCAO or Work Ready Name Address Line 1  \nAddress Line 2  \nCity, State, ZIP  \nFAX: (555) 555-5555","cbCaipGJuk8Qd7Bu","https://ap.wps.com/l/cbCaipGJuk8Qd7Bu","pdf",214623,"English","# Section I - Volunteer and Agency Information\n# Section II - Community Service Activity Information\n# Section III - Agency Certification\n# Section IV - Reporting Changes","[{\"question\":\"Who is authorized to sign this verification form?\",\"answer\":\"The form must be signed by the site manager or supervisor who can officially attest to the volunteer's community service agreement and participation hours.\"},{\"question\":\"What is the purpose of this form in relation to SNAP benefits?\",\"answer\":\"This form is used to document community service hours for individuals subject to Able Bodied Adult Without Dependents (ABAWD) work requirements, helping them maintain their eligibility for time-limited Supplemental Nutrition Assistance Program (SNAP) benefits.\"},{\"question\":\"What is the required procedure if a volunteer stops participating or fails to meet required hours?\",\"answer\":\"The agency must report such changes to the Pennsylvania Department of Human Services within 10 days of the date the change occurred using Section IV of the form.\"}]","Pennsylvania Department of Human Services - Community Service Volunteer Verification Form | PDF",1789629853]