The Placer County Department of Human Services provides information on how to replace food that was lost or damaged in a qualifying emergency using CalFresh.

A form must be submitted within 10 days of the end of an event, such as a power outage. Sometimes counties extend the deadline beyond 10 days.

To Apply for Replacement Benefits

Complete and submit Replacement or Disaster Supplement Affidavit (CF 303) to apply for CalFresh replacement benefits after disaster.

• In Person | People can visit an in-person office for service.
• Online | BenefitsCal.com

Forms

Fax the completed form to 530-265-9860.

• English CF 303 form
• Spanish CF 303 form

Locations

• Auburn | Human Services Office
  • 11434 B Avenue, Auburn, CA 95603
  • 888-385-5160
• Rocklin | Human Services Office
  • 1000 Sunset Boulevard, Suite 220, Rocklin, CA 95765
  • 888-385-5160
• North Lake Tahoe | Human Services Office
  • 5225 N Lake Boulevard, Carnelian Bay, CA 96140
  • 888-385-5160

Web pages

• Home - https://www.placer.ca.gov/2096/Human-Services
• Benefits Replacement Forms -
  • English - https://www.cdss.ca.gov/Portals/9/Additional-Resources/Forms-and-Brochures/2020/A-D/CF303.pdf?ver=2021-10-21-083524-990
  • Spanish - https://cdss.ca.gov/Portals/9/TranslatedForms/Spanish/CF_303_Spanish.pdf
• Apply for/Access your Public Benefits Online (Medi-Cal, CalFresh, CalWORKS, Disaster CalFresh, General Assistance) - www.benefitscal.com
• Forms - https://cdss.ca.gov/inforesources/forms-brochures