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The penalties could include prosecution for Intentional Program Violation under Federal and State law or disqualification from the Food Stamp program following a finding of Intentional Program Violation at an Administrative Disqualification Hearing or a charge of perjury for a false claim. Signature Date Witness--if signature is by x or other mark FOR OFFICE USE ONLY Coupon value Date mailed Original ATP No. Issuance Action Code Replacement ATP No. No. in Food Stamp Unit DSS-1678 11/93...
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A replacement affidavit is a legal document that is used to replace a previously filed affidavit.
Anyone who needs to update or correct information on a previously filed affidavit may be required to file a replacement affidavit.
To fill out a replacement affidavit, you must provide your personal information, the date of the original affidavit, and the corrections or updates that need to be made.
The purpose of a replacement affidavit is to ensure that accurate and up-to-date information is on file with the appropriate authorities.
The replacement affidavit must include any corrections or updates to the information that was provided in the original affidavit.
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