Program research record
• Jurisdiction and responsible authority:
• Program and official source:
• Question being researched:
• Source publication or update date:
• Date verified:
• Confirmed facts:
• Uncertainty or conflicting information:
• Eligibility decision-maker:
• Authorization required before spending or beginning work:
• Questions to ask the human decision-maker:
• Next verification date:
Do not include case numbers, government identifiers, benefit letters, medical records, credentials, or private correspondence.