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DEPARTMENT OF HEALTH SERVICES
Division of Medicaid Services
F11092A (07/2023)STATE OF WISCONSIN
Wis. Admin. Code DHS 107.10(2)FORWARDHEALTHPRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL)
FOR GROWTH
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How to fill out replacement foodshare benefits f-00330
How to fill out replacement foodshare benefits f-00330
01
Obtain a Replacement FoodShare Benefits F-00330 form from your local FoodShare office or online.
02
Provide your personal information including your name, address, and FoodShare ID number.
03
Indicate the reason why you are requesting replacement benefits (e.g. lost, stolen, damaged).
04
Sign and date the form.
05
Submit the completed form to your local FoodShare office either in person, by mail, or fax.
Who needs replacement foodshare benefits f-00330?
01
Individuals who have lost their FoodShare benefits card.
02
Individuals whose FoodShare benefits card has been stolen.
03
Individuals whose FoodShare benefits card has been damaged.
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What is replacement foodshare benefits f-00330?
Replacement foodshare benefits f-00330 are benefits provided to eligible individuals or families to replace lost or stolen foodshare benefits.
Who is required to file replacement foodshare benefits f-00330?
Individuals or families who have lost or had their foodshare benefits stolen are required to file for replacement foodshare benefits f-00330.
How to fill out replacement foodshare benefits f-00330?
To fill out replacement foodshare benefits f-00330, individuals or families need to contact their local food assistance office and request the necessary forms. They will need to provide information about the lost or stolen benefits.
What is the purpose of replacement foodshare benefits f-00330?
The purpose of replacement foodshare benefits f-00330 is to ensure that eligible individuals or families receive the benefits they are entitled to, even if their original benefits are lost or stolen.
What information must be reported on replacement foodshare benefits f-00330?
On replacement foodshare benefits f-00330, individuals or families must report details about the lost or stolen benefits, as well as provide any relevant supporting documentation.
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