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This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 27-130
for the current year.
DSHS Form 27-130 Authorization for Alternate Ebt Cardholder - Washington
What Is DSHS Form 27-130?
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DSHS Form 27-130?
A: DSHS Form 27-130 is the Authorization for Alternate EBT Cardholder in Washington.
Q: What is an EBT card?
A: An EBT card is a card that is used to access government benefits electronically in Washington.
Q: What is the purpose of DSHS Form 27-130?
A: The purpose of DSHS Form 27-130 is to authorize someone to act as an alternate EBT cardholder on behalf of the primary cardholder.
Q: Who can be an alternate EBT cardholder?
A: An alternate EBT cardholder can be someone chosen by the primary cardholder, such as a family member or trusted individual.
Q: Is there a fee to request an alternate EBT cardholder?
A: No, there is no fee to request an alternate EBT cardholder.
Q: Can I change or revoke the authorization of an alternate EBT cardholder?
A: Yes, you can change or revoke the authorization of an alternate EBT cardholder at any time by submitting a new DSHS Form 27-130 to DSHS.
Q: What can an alternate EBT cardholder do?
A: An alternate EBT cardholder can use the EBT card to access and use the benefits on behalf of the primary cardholder.
Q: What should I do if my EBT card is lost or stolen?
A: If your EBT card is lost or stolen, you should immediately contact the EBT customer service hotline to report it and request a replacement card.
Q: Can I have multiple alternate EBT cardholders?
A: Yes, you can have multiple alternate EBT cardholders, but each one needs to be authorized separately using DSHS Form 27-130.
Form Details:
- Released on December 1, 2015;
- The latest edition provided by the Washington State Department of Social and Health Services;
- Easy to use and ready to print;
- Available in Somali;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of DSHS Form 27-130 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
