Field offices in Arkansas, Louisiana, New Mexico, and Oklahoma should continue to
            follow all other instructions in SI 00830.400. with the exception of asking for written confirmation of AFDC information provided orally by the AFDC
            State agency.
         
         The SS-RVI-310, AFDC Grant Information, is optional and can be used to record oral
            information obtained from the AFDC agency.
         
         Current procedures continue to apply in Texas.
         AFDC GRANT INFORMATION
         Date: __________ SSN: ________________
         SSI Recipient: ________________________________________________
         Date of SSI Entitlement: ____________________
         Approximate Date of Receipt of First SSI Check: _______________
         The following information was obtained from:
         AFDC Caseworker: ___________________ Phone #: _______________
         Agency: ________________ Location: ________________________
         The AFDC grant amount for each month the individual is both entitled to SSI and included
            in the AFDC grant is:
         
         
            
               
                  
                  
                  
                  
                  
               
               
                  
                  
                     
                     | Mo/Yr | Thru | Mo/Yr | Monthly Grant Amount | Grant Amount if SSI Recipient Is Removed | 
                  
                     
                     | ______ | - | ______ | __________ | _____________________ | 
                  
                     
                     | ______ | - | ______ | __________ | _____________________ | 
                  
                     
                     | ______ | - | ______ | __________ | _____________________ | 
                  
                     
                     | ______ | - | ______ | __________ | _____________________ | 
                  
                     
                     | ______ | - | ______ | __________ | _____________________ | 
               
            
          
         Name of Caretaker included in the grant: _______________________
         Names of all persons included in the AFDC grant: _______________
         The last month the SSI recipient will be included in the AFDC grant is _______________________.
          
         Remarks: _______________________________________________________
         ________________________________________________________________
         ________________________________________________________________
         Information obtained by: ________________________________
         (Name and Position)
         SS-RVI-310 (04/94)