Form PA 1795 is the Pennsylvania Department of Human Services verification document called “Household Members/Living Expenses,” used mainly in SNAP cases to confirm who lives in your home and what you pay for shelter and utilities. Your County Assistance Office (CAO) sends it when it needs your landlord, housing agency, or you to document rent, mortgage, taxes, insurance, or utility costs so the shelter deduction can be applied to your benefit calculation.1Pennsylvania Department of Human Services. Operations Memorandum 26-02-01 – SNAP Shelter and Utility Verification Changes
When the CAO Will Ask You for It
The CAO verifies shelter and utility costs at your initial SNAP application and whenever you report a change of address. At reapplication, it only re-verifies if there is no verified shelter information on file for your current address or if something looks inconsistent. During Semi-Annual Reporting, shelter costs get re-verified only when you report a change.1Pennsylvania Department of Human Services. Operations Memorandum 26-02-01 – SNAP Shelter and Utility Verification Changes
When verification is needed, the CAO sends a PA 253 notice requesting proof and often encloses a blank PA 1795. You have a minimum of 10 days from the date on that notice to return the completed form or acceptable alternative documentation.1Pennsylvania Department of Human Services. Operations Memorandum 26-02-01 – SNAP Shelter and Utility Verification Changes The clock runs from the notice date, not the day the envelope lands in your mailbox, so open it right away.
Why it matters: SNAP calculates a shelter deduction when your housing and utility costs exceed 50 percent of your countable income after other deductions are applied. If the CAO has no verified shelter figures, it cannot give you that deduction, and your benefit comes out lower.2Pennsylvania Department of Human Services. SNAP 560.8 Shelter/Utility Deduction
What Goes on the Form
PA 1795 asks for two things: the people in your household and the costs of keeping a roof over them. The CAO may hand the blank form to your landlord or housing agency to fill out, or give it to you so you can get it completed and returned.1Pennsylvania Department of Human Services. Operations Memorandum 26-02-01 – SNAP Shelter and Utility Verification Changes Under Pennsylvania regulations, you are the primary source of eligibility information, which means the duty to get the form back to the CAO sits with you first. The CAO will help if age, disability, or language barriers make gathering documents harder on your own.3Pennsylvania Code and Bulletin. 55 Pa Code 201.1 – Policy
If your landlord drags their feet or refuses outright, tell your caseworker. The CAO can make a collateral contact directly, attaching a consent form to its written request.4Pennsylvania Department of Human Services. Collateral Contacts
Which Shelter Costs Count
Allowable shelter expenses for the SNAP deduction include rent, mortgage principal and interest, property taxes, homeowner’s insurance on the structure, and condominium or association fees. Unreimbursed repair costs after a fire, flood, or similar disaster also count. Insurance on furniture or personal belongings does not qualify.2Pennsylvania Department of Human Services. SNAP 560.8 Shelter/Utility Deduction
One recurring snag: if someone outside your household pays your rent or utility bill directly to the landlord or utility company, that third-party vendor payment is generally not counted as an allowable shelter expense. The only exception is when those payments happen sporadically rather than as a routine arrangement.2Pennsylvania Department of Human Services. SNAP 560.8 Shelter/Utility Deduction
Fill in your figures accurately. Inflating a rent amount to boost your deduction is treated as fraud, not a paperwork mistake.
Documents You Can Send Instead
PA 1795 is one option, not the only one. The CAO accepts several alternatives:
- For rent or mortgage: a mortgage statement, a rent receipt, a written statement from the landlord or property manager, or a current lease.
- For property taxes: bills or statements from the taxing authority.
- For property insurance: bills or statements from the insurer, or a copy of a current payment receipt.
Any of these can stand in for a completed form or supplement one.2Pennsylvania Department of Human Services. SNAP 560.8 Shelter/Utility Deduction If you already have a current lease that shows your rent, that alone may satisfy the request, and you don’t need your landlord to touch the PA 1795 at all.
If you are homeless or genuinely have no shelter or utility expenses, the CAO can take your statement without requiring verification, unless what you report looks inconsistent or questionable.1Pennsylvania Department of Human Services. Operations Memorandum 26-02-01 – SNAP Shelter and Utility Verification Changes
Getting the Form Back to the CAO
You have three main ways to return the completed PA 1795 or alternative proof.
The quickest is the myCOMPASS PA mobile app, which lets you photograph documents with your phone and send them in electronically.5Pennsylvania Department of Human Services. MyCOMPASS PA You can also upload through the COMPASS web portal at compass.dhs.pa.gov. Digital submissions carry a timestamp, which helps if there is ever a dispute about whether you met the 10-day deadline.
Your local CAO also keeps a drop box so you can leave documents without waiting in line.6Commonwealth of Pennsylvania. County Assistance Offices (CAO) Make a copy for yourself before you drop anything off. The CAO directory at pa.gov/agencies/dhs/contact/cao-information lists offices by county; check the address before mailing, since documents sent to the wrong office tend to disappear.
The most cautious route is hand-delivering the form and asking the front desk for a date-stamped receipt. That receipt is hard evidence of your submission date if the CAO ever says it didn’t arrive on time.
What Happens If You Miss the Deadline
This is the part most applicants misread. Failing to return PA 1795 or other shelter documentation will not cause the CAO to deny your application or close your case. Instead, the CAO drops your shelter and utility deductions and processes the case without them.1Pennsylvania Department of Human Services. Operations Memorandum 26-02-01 – SNAP Shelter and Utility Verification Changes The result is a smaller monthly SNAP amount, often meaningfully smaller, because the shelter deduction is frequently the largest one in the benefit calculation.
You can still turn in the verification after your case has been processed. Once the CAO receives acceptable proof, it should recalculate your benefits with the shelter deduction included going forward. If you think the deduction should have been applied retroactively, bring it up with your caseworker or file an appeal.
If You Disagree With the Decision
When the CAO reduces your benefits over a verification issue and you believe the call is wrong, you have the right to appeal. The notice you receive will state the deadline and how to file.7Commonwealth of Pennsylvania. Request a Hearing or Appeal from DHS
For SNAP, you can appeal either orally or in writing. That oral option is unique to food assistance; cash assistance and Medical Assistance appeals must be in writing and signed by you. File with the CAO that made the decision. The office date-stamps the request, reviews it, and offers an agency conference to try to resolve the issue without a formal hearing. If that doesn’t settle things, the appeal is sent to the Bureau of Hearings and Appeals. Final administrative action must occur within 60 days on SNAP appeals.8Legal Information Institute. 55 Pa Code 275.4 – Procedures
If you file the appeal before the effective date of the reduction shown on your notice, your benefits may continue at the current level while the appeal is pending. Interpretation services and disability accommodations are available at no cost; note any needs on the Fair Hearing Form when you file.