PA 1896 SNAP Replacement Form: Deadlines, Filing, and Denials

The PA 1896 SNAP replacement form is a one-page affidavit Pennsylvania SNAP recipients sign to get replacement benefits after food bought with their EBT card is destroyed in a household disaster. Call your County Assistance Office (CAO) within 10 days of the incident to report the loss, then get the signed form to the office within 10 days of that call. Once the claim is verified, the replacement value is loaded back onto your existing EBT card, up to one month’s allotment.1Pennsylvania Department of Human Services. Affidavit for Replacement of Food Destroyed in a Household Disaster

What Losses the Form Covers

Federal rules require the state to replace SNAP-purchased food destroyed in a “household misfortune.”2eCFR. 7 CFR 274.6 – Replacement Issuances and Cards to Households That covers house fires, flooding, severe storms, extended power outages, and refrigerator or freezer breakdowns that spoil the food inside. The event must be outside your control and must have physically destroyed food you already bought with SNAP.

A few things fall outside the form. A lost or stolen EBT card is handled through a separate card-replacement process, not PA 1896. Food you forgot about or gave away doesn’t qualify. And if a presidential disaster declaration triggers Disaster SNAP (D-SNAP) in your area, you can’t collect both D-SNAP and a household misfortune replacement for the same event, so ask your CAO which path applies.2eCFR. 7 CFR 274.6 – Replacement Issuances and Cards to Households

The Two 10-Day Deadlines

Two separate 10-day clocks run on this process, and missing either one ends the claim.

Write down the exact date and time of your first call. You may need to prove the form arrived within the second 10-day window.

Filling Out the Form

You can pick up PA 1896 at your local CAO or download it from the Pennsylvania DHS SNAP page at dhs.pa.gov/SNAP. English and Spanish versions are available.1Pennsylvania Department of Human Services. Affidavit for Replacement of Food Destroyed in a Household Disaster

The form is short. Most of the care goes into being accurate about what you lost. Here is what each field asks for:

  • Client name and Social Security number. Use the name on your SNAP case. The administrative boxes at the top (case identification, record number, county code) may be pre-filled by your caseworker or left for the office.
  • Dollar amount of food lost. Enter the total value of SNAP-purchased food that was destroyed. This figure cannot exceed your household’s maximum monthly SNAP allotment for the month the loss happened. If you lost $150 worth of food but your monthly allotment is $234, enter $150, not the full allotment. Only claim what you actually lost.3eCFR. 7 CFR 274.6 – Replacement Issuances and Cards to Households
  • Date of the loss. The actual day the food was destroyed, not the day you noticed it or the day you’re completing the form.
  • Reason for the loss. A brief, factual description: power outage, fire, flood, freezer failure.
  • Signature and date. The certification is sworn under penalty of perjury. Signing confirms the information is true, and intentionally misrepresenting the facts can result in denial, disqualification from SNAP, fines, or jail time.1Pennsylvania Department of Human Services. Affidavit for Replacement of Food Destroyed in a Household Disaster

Documentation to Attach

Before issuing replacement benefits, the agency has to verify the destruction actually happened. Federal rules allow verification through a collateral contact, documentation from a community agency such as a fire department or Red Cross, or a home visit.2eCFR. 7 CFR 274.6 – Replacement Issuances and Cards to Households Attaching proof when you submit the form speeds the decision and reduces the chance the claim stalls while a caseworker tracks down confirmation.

What counts as good documentation depends on the cause:

  • Power outage. A letter or outage confirmation from your utility company, or news coverage of a widespread outage in your area.
  • Fire or flood. A fire department report, a Red Cross damage assessment, or a police report.
  • Appliance failure. A repair receipt or written statement from a technician confirming the refrigerator or freezer malfunctioned. The agency should not require you to bring in the spoiled food.

If you can’t gather documentation yourself, your caseworker can verify through collateral contacts: calling the fire department, checking utility outage records, or scheduling a home visit.

How to Submit the Form

Once the form is signed and your documents are together, you have several options for getting them to your CAO:

  • Upload online. Scan or photograph the completed form and upload it through the COMPASS portal or the myCOMPASS PA mobile app. This is the fastest method and leaves you with a digital record.4Pennsylvania Department of Human Services. COMPASS
  • Drop box. Most CAOs have an exterior drop box accessible outside business hours.
  • Mail. Send the package to your assigned CAO. Use certified mail or request a tracking number so you can prove timely delivery.
  • Fax. Fax the form and attachments to the number listed for your CAO.

To find your office’s address, phone, fax, and drop box location, use the DHS county assistance office directory.5Pennsylvania Department of Human Services. County Assistance Offices (CAO) Keep a copy of everything you send, including any confirmation or tracking receipt.

What Happens After You Submit

Your caseworker first confirms a valid SNAP issuance was made to your household, then verifies the misfortune occurred. Once the claim checks out, federal rules require the agency to issue replacement benefits within 10 days of your original loss report or within two working days of receiving the signed affidavit, whichever is later.2eCFR. 7 CFR 274.6 – Replacement Issuances and Cards to Households If you report the loss and submit the form on the same day, replacements can appear on your EBT card within a few days.

The replacement equals the verified value of the destroyed food, not your full monthly allotment by default. If you claimed $90 and the agency verifies $90, that’s what gets loaded. The cap is one month’s allotment for the month the loss occurred.1Pennsylvania Department of Human Services. Affidavit for Replacement of Food Destroyed in a Household Disaster

If Your Claim Is Denied

A denial comes with a written notice explaining the decision and how to challenge it. Federal SNAP regulations give you 90 days from the date of the agency’s action to request a fair hearing.6eCFR. 7 CFR 273.15 – Fair Hearings The letter will list the specific instructions and contact information for filing an appeal with Pennsylvania’s Bureau of Hearings and Appeals.7Pennsylvania Department of Human Services. Request a Hearing or Appeal from DHS

Common reasons for denial include missing one of the two 10-day deadlines, giving too little detail about what was lost, or the agency being unable to verify the incident. If verification was the problem, pull together stronger proof (a utility outage letter, a fire department report) and reference it in your hearing request.