I authorize the Blackfeet Tribal NEW Program to exchange the information to determine and maintain my TANF eligibility with the following agencies and programs:
- Montana State Unemployment
- Social Security Administration
- Indian Health Service
- Glacier/Pondera Office of Public Assistance
- Blackfeet Chemical Dependency
- Blackfeet Tribal Court
- Blackfeet Community College
- Public Schools
- Employers
- Blackfeet Head Start Programs
- Man Power Programs
- Family Solutions
- Blackfeet Housing Authority
- Tribal/State WIOA
- State Voc. Rehab
- Tribal TANF
- Blackfeet Tribal Enrollment
I understand that any information obtained and/or exchanged will pertain to my NEW eligibility and participation requirements only. The law requires that the information will be kept confidential and that it will be used only for purposes of legal and investigative action concerning fraud.
I further understand that any information obtained may be released to the proper government agency, court, or law enforcement agency for purposes of legal and investigative action concerning fraud.
The release of information will remain in effect for one year or until I request in writing to rescind authorization.