Print Version of Forms
Application/Redetermination Form (print version) DFA-2-Use to apply for any financial benefits
Snap Application (print version) DFA-SNAP-1- Use to apply for SNAP ONLY benefits
SNAP Change Reporting Form (print version) DFA-SNAP-2-Use to report changes in household circumstances
SNAP is administered by the WV DHHR and governed by federal law and regulations of the US Department of Agriculture, Food Nutrition Services. SNAP provides monthly benefits to help eligible households buy food. Eligibility to receive benefits is based on household size, income, assets and some household expenses as determined by the federal government. The asset limit is $2,750 for households. NOTE: Most households will not be subject to the asset limit but if at least one person is at least age 60 or disabled, the asset limit is $4,250.
Most people must pass a gross income test and then a net income test. Before total income is compared to the federal net income limits, certain deductions are applied to the income, such as: 20% earned income disregard, child care costs, excess shelter/utility costs, court-ordered child support paid out, etc.
The amount of SNAP benefits issued to eligible persons is based on household size and countable income, after all deductions are applied. Households with an elderly or disabled person are given special consideration. In addition to the higher asset limit, there is no gross income test and more excess shelter/utility costs can be deducted, and medical expenses over $35 per month.
SNAP benefits may only be used to purchase food for human consumption and seeds/plants to grow food at home. Food Stamp benefits cannot be used for: household items, grooming products, tobacco, alcohol products, pet food, etc.
To make a complaint regarding Supplemental Nutrition Assistance Program (SNAP) to the Bureau for Children and Families Call Client Services at 1-800-642-8589
To File A Civil Rights Program Complaint
In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), religious creed, disability, age, political beliefs, or reprisal or retaliation for prior civil rights activity.
Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the agency (state or local) where they applied for benefits. Individuals who are
deaf, hard of hearing or have speech disabilities may contact USDA through the Federal
Relay Service at (800) 877-8339.
To file a program discrimination complaint, a Complainant should complete a Form AD-
3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (833) 620-
1071, or by writing a letter addressed to USDA. The letter must contain the complainant's name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to:
Food and Nutrition Service, USDA
1320 Braddock Place, Room 334
Alexandria, VA 22314; or
(833) 256-1665 or (202) 690-7442; or
3. Email: FNSCIVILRIGHTSCOMPLAINTS@usda.gov
This institution is an equal opportunity provider.