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Reset FormINDIANA WIC PROGRAM LOST, STOLEN, OR DESTROYED CHECK REPLACEMENT
State Form 54152 (R4 / 1113)Indiana State Department of HealthINSTRUCTIONS:1. Forward this completed form to the State WIC
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How to fill out indiana wic program lost
How to fill out indiana wic program lost
01
Gather all necessary documents such as identification, proof of address, proof of income, and proof of pregnancy or breastfeeding.
02
Locate your nearest WIC clinic or agency in Indiana.
03
Contact the WIC agency to schedule an appointment.
04
Attend the appointment and bring all necessary documents.
05
Inform the WIC staff that you have lost your WIC program and need a replacement.
06
Complete the required forms and provide any additional information as requested.
07
Review and sign the application.
08
Receive your new WIC program once it is processed.
Who needs indiana wic program lost?
01
Anyone who has lost their Indiana WIC program.
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What is indiana wic program lost?
The Indiana WIC program lost refers to the reporting of lost or stolen WIC cards or benefits in Indiana.
Who is required to file indiana wic program lost?
Participants in the Indiana WIC program are required to file a report if they have lost their WIC card or benefits.
How to fill out indiana wic program lost?
To fill out the Indiana WIC program lost report, participants can contact their local WIC office or the Indiana WIC program hotline for assistance.
What is the purpose of indiana wic program lost?
The purpose of the Indiana WIC program lost report is to ensure the security of WIC benefits and prevent unauthorized use.
What information must be reported on indiana wic program lost?
Participants must report their name, address, WIC ID number, and the circumstances of how their WIC card or benefits were lost.
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