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Supplemental Nutrition Assistance Program (SNAP)

Stolen SNAP Benefits Program

Affidavit of Fraudulent Use of an EBT Card

The Stolen Supplemental Nutrition Assistance Program (SNAP) Benefits Program, implemented and funded by the United States Department of Agriculture (USDA) Food and Nutrition Services (FNS). If your benefits were stolen due to skimming and/or cloning, you may be eligible for reimbursement. To submit a claim, you must report the theft within 90 days of the date the benefits were stolen.

How to check your EBT history:

Please note, if your SNAP benefits have been skimmed and have not reported your EBT card lost or stolen, your account is likely still at risk. No replacement benefits may be issued until you have reported your compromised EBT card lost or stolen. To report your card stolen, request a new card, and change your PIN, please call EBT Customer Service at (888) 356-3281.

The Department will review your claim within 10 business days of receipt. If your claim is approved, the stolen benefits will be reimbursed, either the exact amount stolen or the equivalent of two months of SNAP benefits before the theft, whichever is less. Once your claim is validated, the benefits will be available for use on your Electronic Benefit Transfer card the following day.

If your benefits were stolen,  please fill out the below form in its entirety.

 

Indicates required field
 

Household Information

Your case number has ten digits and start with a 1. It can be accessed through your MyAccess account.

Benefit Theft Information

Transaction #1

Do you have another fraudulent transaction to add?

Transaction #2

Do you have another fraudulent transaction to add?

Transaction #3

Do you have another fraudulent transaction to add?

Transaction #4

Do you have another fraudulent transaction to add?

Transaction #5

Do you have another fraudulent transaction to add?

Transaction #6

Do you have another fraudulent transaction to add?

Transaction #7

Do you have another fraudulent transaction to add?

Transaction #8

Do you have another fraudulent transaction to add?

Transaction #9

Do you have another fraudulent transaction to add?

Transaction #10

Certification

By signing below, I hereby acknowledge that I have read and understand the below statements.

  • I must complete, sign, and submit this form to request the replacement of stolen benefits.
  • The information provided in this form is true and accurate.
  • The submission of this request does not guarantee that my benefits will be replaced.
  • The transaction(s) identified on this Affidavit were not authorized or signed by me or by anyone acting upon my authority or with my consent or knowledge. I have examined all the transactions reported above, and, in each instance, I did not originate the transaction nor authorize it. Neither I, nor any person(s) authorized to use my EBT Card, have received any benefit, directly or indirectly, from the unauthorized use of my EBT card. 
  • I swear this affidavit is true and understand that making a false sworn statement and/or misrepresentation of theft constitutes an intentional program violation (IPV), as described in 7 CFR 273.16(c), which may subject the household to disqualification from participation in the SNAP Program and may be punishable by fines and/or imprisonment.
     

STOP! 

Please press submit only once. 

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Submitting additional claims may likely delay the review and possible replacement of your benefits.

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