PEBT Eligibility Application

To complete the P-EBT application for Virtual and/or Homeschool students:

List all household members and the school name and grade level for each child.  For any person, including children, with no income, you must check the “No Income Box”.

If the household does not have a SNAP or OWF 7-digit case number, skip this part.

If any child you are applying for is homeless, migrant, or a runaway check the appropriate box. If not, skip this part.

For each household member, list each type of income received for the month.  For earnings, be sure to list the gross income – not the take-home pay. Gross income is the amount earned before taxes and other deductions and can be found on pay stubs. For other income, list the amount each person received assistance from welfare, child support, alimony, pensions, retirement, Social Security, Supplemental Security Income (SSI), Veteran’s benefits (VA benefits), and disability benefits. Under All Other Income, list Worker’s Compensation, unemployment or strike benefits, regular contributions from people who do not live in your household and any other income. Do not include income from SNAP, FDPIR, WIC, federal education benefits and foster payments received by the family from the placing agency.  For ONLY the self-employed, report income after expenses under Earnings from Work. This is for your business, farm, or rental property.  If you are in the Military Privatized Housing Initiative or receive combat pay, do not include these allowances as income.