EBT 2259 (1 23) - Report Of Electronic Theft Of Benefits - Required Form - No substitutes Permitted-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Recipient Information' section. Enter your last name, first name, middle initial, phone number, EBT card number, city, state, zip code, and email address.
3. In the 'Incident Information' section, indicate whether you were scammed or if your card was skimmed. Provide details about when and where the incident occurred.
4. List all electronic theft transactions in the designated area. Include transaction dates, amounts stolen, and locations of thefts.
5. Complete the 'Declaration of Truth' section by signing and dating the form to confirm that all information provided is accurate.
6. Once completed, save your form and submit it to your county worker as instructed.

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