INCOMPLETE HRF/CSR
ISSUE DATE: 03/2026
If the program participant submits an incomplete Household Report Form (HRF) (DHS-2120) (PDF) or Combined Six-Month Report (CSR) (DHS-5576) (PDF) to the county agency or Tribal Nation during the processing month, attempt to contact them and complete the HRF or CSR over the phone. If the attempt is unsuccessful, return the incomplete form along with the Notice of Late or Incomplete Household Report Form, Health Care Renewal Form or Combined Six-Month Report or Recertification (DHS-2414) (PDF). Clearly state on the form what the program participant must do for the form to be complete, including contacting you to complete it over the phone. MAXIS will issue a closing notice for failure to return a complete form on the 16th of the month if the program participant has not returned a complete form. See 0026.12 (Timing of Notices).
If the program participant resubmits an incomplete form after you send a DHS-2414, but before the 10-day request period has ended, attempt to contact them and complete the HRF or CSR over the phone. If the attempt is unsuccessful, return the incomplete form with another DHS-2414 with a new 10-day request period. Clearly say on the form and DHS-2414 what the program participant must do for the form to be complete, including contacting you to complete it over the phone. See 0007.03.06 (Processing a Late HRF), 0007.12.03 (What Is a Complete HRF/CSR).
If the program participant resubmits an incomplete form after you send a timely DHS-2414 and after the 10-day request period has ended, the earlier notice remains valid. Attempt to contact them and complete the HRF or CSR over the phone. If the attempt is unsuccessful, return the incomplete form again and clearly state what the program participant must do to complete it.
If you do not receive a complete form by the last day of the processing month and you sent the program participant a DHS-2414 timely, the case remains closed for the program that required the form. See 0007.03.06 (Processing a Late HRF), 0007.03.07 (Processing a Late Combined Six-Month Report).
If you receive a complete form by the last day of the processing month, and the program participant is eligible, the case must remain open.
PREVIOUS REVISIONS
| Date | Notes |
|---|---|
| 10/2021 | updates information throughout about what to do if an incomplete Household Report Form (HRF) or Combined Six-Month Report (CSR) is returned. |
| 01/2020 | update the form title to Notice of Late or Incomplete Household Report Form, Health Care Renewal Form or Combined Six-Month Report or Recertification (DHS-2414) due to title change. No policy was changed. |
| 04/2015 | in the 1st paragraph updates the form name of Notice of Late or Incomplete Household Report Form, Health Care Renewal Form or Combined Six-Month Report (DHS 2414) due to name change. |
Report this page