Section 22.33. Responsibilities of the applicant in the application process

The applicant has the responsibility to conform to the following:

(1) Complete the PACE application form legibly and accurately.

(i) Answer questions fully.

(ii) Present necessary evidentiary documents under the following requirements:

(A) Regarding residence, one of the documents listed in § 22.22(b) (relating to residence provisions) or other documentation of residence acceptable to the Department, except when the application has the applicant’s name and current address preprinted on it.

(B) Regarding age, one of the documents listed in § 22.23(c) (relating to age provisions), or two of the other types of documentation of age listed in § 22.23(d).

(C) Regarding income, documents required to substantiate each source of income, as defined in § 22.2 (relating to definitions) and as set forth in § 22.24(e) (relating to income provisions), whenever required to do so by the Department.

(D) Regarding qualification for other benefits, information identifying participation in any of the other programs referred to in § 22.25 (relating to other third-party benefits).

(iii) Read the certification and authorization statement.

(iv) Sign or mark the application form.

(v) Obtain signatures required by the Department on the instructions which accompany the application form.

(2) Submit the completed PACE application form to the Department.

(3) Assist the Department in securing evidence which corroborates the applicant’s statements when necessary.

(4) Consent to a review by the Department of information submitted on the application form, with reasonable prior notice to the applicant, if selected for review. PACE eligibility may be denied if the applicant refuses to cooperate with the request.

The provisions of this § 22.33 adopted June 15, 1984, effective June 16, 1984, 14 Pa.B. 2109; corrected July 6, 1984, effective June 16, 1984, 14 Pa.B. 2331; amended March 29, 1985, effective March 30, 1985, 15 Pa.B. 1163; amended December 14, 1990, effective December 15, 1990, 20 Pa.B. 6143. Immediately preceding text appears at serial pages (96829) to (96830).

Notation

Cross References

This section cited in 6 Pa. Code § 22.11 (relating to general payment principles).