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Commonwealth of Virginia Department of Social Services Supplemental Nutrition Assistance Program (SNAP)
Renewal Application for Elderly Simplified Application Project (ESAP)
To:
ESAP/SNAP Case Number
County/City
Department of Social Services Address
City, State, Zip
Telephone Number
Your ESAP eligibility will end on:
Your eligibility for ESAP benefits is expiring. You must file a new application by ________________________ for uninterrupted benefits, and be found eligible based on the information you give. If you do not file an application by this date, there may be an interruption in your benefits.
We can only start the renewal process once you file an application. You or your authorized representative may complete the application attached here. The application must have at least your name, address, and your signature. You may file the application: • in person at the address shown above; • by mail, fax, by e-mail; or
Please use only one method to renew. • apply online at https://commonhelp.virginia.gov/access/.
In most instances, we will not need an interview to process your renewal application. You may request to have an interview however. If we need an interview or if you request one, we will let you know when and how the interview will occur. We will also let you know if we need additional information.
If you do not agree with the action taken on your application, you may appeal the action. You must file your appeal within ninety days of the agency’s notice to you. You may get an appeal form from this department or from the Virginia Department of Social Services, 5600 Cox Road, Glen Allen, VA 23060, or you may call 1-800-552-3431.
Benefit Program Specialist Date
032-03-729D-01-eng (09/2024)