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Click ‘Get Form’ to open the DSS-1678 in the editor.
Begin by entering your county and FNS case number at the top of the form. This information is crucial for processing your request.
Fill in the date of report and issuance month/year to provide context for your affidavit.
Complete your personal details, including your name and address, ensuring accuracy for correspondence.
In the 'Reason for Report and Replacement Action' section, clearly indicate whether food was destroyed or stolen. If applicable, specify the amount lost.
Review the certification statement carefully, acknowledging the penalties for providing false information before signing.
If necessary, have a witness sign if you are marking with an 'x' or other mark.
Finally, ensure all fields are completed before submitting it back to the Food and Nutrition Services Office within ten calendar days.

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What is the affidavit rule in NC?

Affidavits should always be in the first person. The person making the affidavit must swear or affirm that the contents are true. It should be done before a person authorized to take oaths in respect of the particular kind of affidavit. A person can either affirm or declare instead of swearing if allowed by law.

What is dss 3938 rev 10/15 nc?

The DSS-3938 is designed to assist local district staff in making accurate and consistent assessments of food stamp applicants potential eligibility for expedited food stamp service.

What is the purpose of an affidavit?

Notary. In California, affidavits are signed in the presence of a notary. The notary provides certification that the affiant or deponent, if the affidavit was part of a deposition, signed the document in front of the notary, and that the signer did so in person.

What happens when you file an affidavit?

An affidavit is a statement given under oath that its contents are true and accurate. Any false statement or information contained in this affidavit may subject you to prosecution for the felony of perjury, N.C.G.S. 14-209, or under other statutes that prohibit false statements under oath.

dss1678

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