How to Complete the Kentucky PAFS-76 Landlord Information Request Form

The Kentucky PAFS-76 landlord form is a one-page verification document, officially titled “Information Request–Landlord,” that your landlord or property manager completes to confirm your rent and utility costs during a SNAP or Kentucky Transitional Assistance Program case. The Cabinet for Health and Family Services uses what the landlord reports to calculate the shelter deduction on your benefit. You download it from kynect or get one from your caseworker, have the landlord fill it out and sign it, and return it to the Department for Community Based Services.

Where to Get a Blank Form

The quickest way to get a copy is to download the PDF from the kynect benefits website. Go to Help & FAQs, then Printable Forms, and look for “Information Request–Landlord (PAFS-76).”¹

You can also ask the DCBS caseworker handling your case for a copy. Caseworkers often pre-fill the top of the form with your case number and name before handing or mailing it out, which saves the landlord a step.

What Your Landlord Fills In

The form has to be completed by the landlord or property manager. A member of your household cannot sign it, and if one does, DCBS will reject the form.² It asks about three things.

Who Lives at the Address

Twelve numbered boxes are provided for listing every resident. The landlord also indicates whether they are related to anyone on the list and whether they are the landlord or the property manager.² DCBS compares this list against the household size on your application, so the landlord should list every person they know to be living there, not just the names on the lease.

Rent

The rent section asks whether the household is responsible for paying rent and, if so, the dollar amount per week or per month. There are boxes for work-in-exchange-for-rent arrangements and the hours per week involved. A separate block covers outside help: whether HUD Section 8, another agency, or another person pays all or part of the rent, how much, and whether those payments go to the landlord, the tenant, or both.² If you have a Section 8 voucher, the landlord should report your out-of-pocket share and put the subsidy amount in the designated field.

Utilities

The utility section asks whether you are responsible for heating or air conditioning costs and whether you pay for other utilities like water or sewer. It also asks whether utilities are included in the rent, whether they are billed directly to you, whether HUD or another agency pays part, whether a utility payment is deducted from the rent, and whether you received a Home Energy Assistance Program payment of more than twenty dollars at that address.²

At the bottom, the signer certifies that the information is true and correct to the best of their knowledge, prints their name, signs, and provides a mailing address and phone number.

Common Mistakes That Delay Your Case

Most delays with the PAFS-76 come from small omissions rather than big problems. A few things to check before the form goes back:

Write the exact rent amount. If rent is $647, write $647, not $650. Caseworkers compare the figure against the lease, and round numbers often trigger a follow-up request.
Circle week or month. The rent field reads “$ ___ per week month.” Leaving both unmarked forces the caseworker to call for clarification.
List every resident the landlord knows about, even people not on the lease. A name that appears elsewhere in your file but not on the form creates a discrepancy.
Confirm a household member did not sign. The form itself says a household member cannot be the signer.²
Make the contact information legible. If a caseworker cannot reach the landlord to verify something, the whole case stalls.

How to Submit the Completed Form

Once the landlord has signed, you are responsible for getting the form back to DCBS. Three options are available.

Mail the original to P.O. Box 2104, Frankfort, KY 40602, the centralized processing address printed on the form. Keep a photocopy before you send it.²
Fax it to (502) 573-2007 and keep the confirmation page.²
Upload a scan or photo through the Resident Dashboard on the kynect benefits portal, which is usually the fastest route.³

Submit it as quickly as you can. Federal rules give you at least ten days to provide verification, but if your shelter costs are not verified within thirty days of your application date, DCBS can process the case without the shelter deduction, meaning a smaller monthly benefit.⁴ You can submit the form later and have your benefits recalculated, but you may lose some of the retroactive adjustment if the delay was on your side.

What Happens After You Submit

Federal law requires the state to process a SNAP application within thirty days of the filing date, or seven days for households that qualify for expedited service.⁵ When the caseworker receives the PAFS-76, they compare it against your lease, any prior verification records, and what you reported on your application. If the numbers and names match, your shelter deduction is finalized and a notice goes out with your approved benefit amount.

If something doesn’t line up, the caseworker may ask for a signed lease, recent utility bills, or bank statements showing rent payments. Responding quickly keeps the case from being closed or finalized at a lower benefit level.

Why the Utility Answers Matter

The utility checkboxes often make a bigger difference to your benefit than people expect. Federal SNAP rules allow a shelter deduction that includes heating, cooling, electricity, water, sewage, garbage collection, and basic phone and internet service.⁶ If the landlord confirms you pay heating or cooling separately, you are typically eligible for the full standard utility allowance, which is usually higher than what tenants actually spend. If you only pay non-heating utilities like water and sewer, a smaller limited utility allowance applies. If everything is included in the rent, no separate utility allowance is added.

Getting these yes-or-no answers right can shift your monthly benefit by fifty dollars or more, so it is worth reviewing them with the landlord before the form is signed.

Honesty on the Form

The certification at the bottom of the PAFS-76 is a legal statement. Knowingly making a false statement to a government agency is punishable by up to five years in prison and a fine under federal law.⁷ A landlord who inflates rent or misstates utility arrangements to help a tenant qualify for a larger benefit creates risk for both parties, and the state can seek repayment of any overpaid benefits. If your rent genuinely changes between recertifications, report the change to DCBS rather than waiting for the next review.

1
kynect. Printable Forms
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Cabinet for Health and Family Services. PAFS-76 Kentucky Information Request-Landlord Form
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Cabinet for Health and Family Services. kynect benefits
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eCFR. 7 CFR 273.2 – Office Operations and Application Processing
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USDA Food and Nutrition Service. SNAP Application Processing Timeliness
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eCFR. 7 CFR 273.9 – Income and Deductions
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Office of the Law Revision Counsel. 18 USC 1001 – Statements or Entries Generally