FNS (Food Stamps) Replacement/Supplement Request Form

If you are a current North Carolina Food and Nutrition Services recipient or Simplified Nutritional Assistance Program recipient that has suffered a food loss due to a power outage, mechanical failure, benefits stolen under duress, Electronic Benefit Transfer (EBT) fraud loss, or disaster (such as, but not limited to, a fire or flood) you have 10 days from the date of the loss to request a replacement/supplement. The household must complete and sign the DSS 1678 Replacement/Supplement Affidavit form (Spanish version) then mail, fax, drop it off at your County Department of Social Services office or email as available. 

If your electronic FNS benefits have been stolen from your EBT card, please visit this link Card Skimmers and Stolen FNS Benefits to learn more information about how to request for replacement of stolen electronic benefits.