Form DSS-2435R PDF Details

You may complete your recertification online if you have an NCID and Linked Account.

Who completes it: you or your authorized representative must complete this entire form, sign and date the last page.

If you cannot complete it: you will only need to provide a signature, legible name, and address.

Where to return it: bring, mail to us at the above address, or fax your completed form.

Income: attach proof of all income received during the last 30 days.

SSI: any household that only has Supplemental Security Income (SSI) can apply for recertification at the Social Security office.

QuestionAnswer
Form NameForm DSS-2435R
Form Length6 pages
Fillable?Yes
Fillable fields330
Avg. time to fill out55 min
EditionRev 10-2026
Issuing agencyNorth Carolina Department of Health and Human Services, Division of Social Services
Matches the agency's fileYes, checked October 4, 2026
Other namesDSS-2435R, DSS 2435R, NC FNS recertification, Food and Nutrition Services Notice of Expiration and Recertification Form
Official sourceForm DSS-2435R (Rev 10-2026), North Carolina Department of Health and Human Services, Division of Social Services

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