TX HHS Form H1854. Affidavit for Unauthorized Use of Electronic Benefit Transfer (EBT) Benefits

The TX HHS Form H1854, Affidavit for Unauthorized Use of Electronic Benefit Transfer (EBT) Benefits, is a crucial document that helps households report and claim unauthorized use of their Supplemental Nutrition Assistance Program (SNAP) benefits. This form is typically used when a household discovers that their SNAP benefits have been used without authorization.

The form provides clear instructions on how to access and review transaction history through the YourTexasBenefits.com website or mobile app. Households can check their Lone Star Card account balance, transaction history, reset their PIN, freeze and unfreeze their card, and view unauthorized transactions. The form also emphasizes the importance of reporting unauthorized use within 30 calendar days to ensure replacement benefits are issued.

To claim unauthorized use of EBT benefits, households must complete the table with SNAP benefit transaction details, including transaction date(s), amount(s), retailer(s), and retailer(s) address used without authorization. If more than five transactions are unauthorized, additional transactions can be submitted on a separate sheet of paper. The form is an essential tool for households to take control of their benefits and report any suspicious activity.

• Report unauthorized use within 30 calendar days to ensure replacement benefits are issued
• Access transaction history through YourTexasBenefits.com or mobile app
• Check account balance, reset PIN, freeze/unfreeze card, and view unauthorized transactions