DHS-7330-ENG 10-20
CHILDREN AND FAMILY SERVICES
Use the denial notice you received to complete the information below. If you do not attach proof now, you may miss the appeal deadline.
All P-EBT benefits have been issued for eligible children and all P-EBT denials have been sent either by email or mail. Please enter your current address in the Description box below to help us determine if a replacement card is necessary.
Please enter your full name, date of birth, and current address in the Description box below.