Right Column
On-line Forms and Publications E - H
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E Forms
- EA 1 (08/99) - Emergency Assistance Application For Probation
- EA 1 CWS (08/99) - Emergency Assistance Application For Child Welfare Services
- EFA 7A ENG/SP (3/11) - Emergency Food Assistance Program (EFAP) Certification Of Eligibility
- EFA 14 (5/13) - Emergency Food Assistance Program (EFAP) 2013 Income Guidelines
- EFA 15 (5/13) - Alternate Pick-Up Request Form Emergency Food Assistance Program (EFAP) 2013 Income Guidelines
- EP 4 (12/99) - Summary Of FS/Employment & Training Program
F Forms
- FA 7 (4/13) - Fiscal Audit Entrance Conference Questionnaire
- FA 10A (5/13) - Fiscal Audit Summary Of Exit Conference
- FA 10B (4/13) - Fiscal Audit Summary Of Exit Conference Point Sheet(s)1 NO. __
- FC 1 ACKLIST (11/02) - Foster Care Audits And Rates Branch Audit Check List
- FC 2 (11/04) - Statement of Facts Supporting Eligibility For AFDC-Foster Care (FC)
- FC 2 NM (2/12) - Statement of Facts Supporting Eligibility For AFDC-Extended Foster Care (EFC)
- FC 2 CL (11/02) - Audit Contact Log
- FC 3 (11/04) - Determination Of Federal AFDC-FC Eligibility
- FC 3A (Supplement) (11/04) - AFDC-FG/U Worksheet
- FC 3 - ADSI (10/02) - Audit Detail Supportive Information
- FC 4 APTSHEET (10/02) - Audit Findings - Point Sheet
- FC 4 (11/04) - Foster Child Program Choice Indicator
- FC 5 - CLIST (11/02) - Client List
- FC 6 LGHS (11/02) - Listing Of Group Home Staff
- FC 7-WKIndexP (11/02) - Workpaper Numbering/Indexing System Provisional Rate Audits
- FC 8 (10/11) - Federal Eligibility Certification - Adoption Assistance Program
- FC 8 WKIndexNP (11/02) - Workpaper Numbering/Indexing System Non-Provisional Rate Audits
- FC 9 EXIT (11/02) - Foster Care Group Home Audit Record Of Exit Conference
- FC 10 (8/09) - Income And Property Checklist For Federal Eligibility Determiniation - Adoption Assistance Program
- FC 10 TRWTGCALC (11/02) - Training Weighting Calculation Worksheet
- FC 11 (AUDITS) (10/03) - Receipt For Delivery Of Records (Audits)
- FC 18 (11/04) - Notification Of AFDC-Foster Care Transfer
- FC 24 (8/04) - Certification By County Welfare Department For The Reimbursement Of Title IV-E Funds For Pre-Placement Prevention
- FC 25 (10/04) - Outcomes For Emancipated Foster Youth
- FC 26 (10/04) - Transitional Housing Placement Program (THPP)/THP-Plus
- FC 1633A (2/07) - SSI Screening Guide Section A - Disability Screening
- FC 1633B (2/07) - SSI Screening Guide Section B - Financial Screening
- FC 1633C (2/07) - SSI Screening Guide Section C - Application Inforamtion
- FC 1633D (2/07) - SSI Assessment Tool
- FC 1637 (12/10) - 90-Day Transition Plan
- FCR 1FFA (12/04) - Foster Family Agency - Data And Certification Sheet
- FCR 2FFA (5/09) - Program Description Checklist
- FCR 3FFA (7/03) - Days Of Care Schedule
- FCR 12FFA (2/05) - Total Program Cost Display (FCR 12 FFA)
- FCR 16 (9/09) - Group Home Shelter Costs, Self-Dealing Transactions Declaration And Survey
- FS 11 ENG/SP (9/12) - Notice To All CalFresh Recipient - Important - Please Read
- FS 11B ENG/SP (4/09) - Notice To All Food Stamp Recipients Important - Please Read - Things You Need To Know
- FS 11C ENG/SP (11/10) - Notice To All Food Stamp Recipients Important - Please Read
- FS 12 ENG/SP (5/05) - Notice To All Food Stamp Households With Elderly And/Or Disabled Members
- FS 17 ENG/SP (9/99) - Notice To All Food Stamp Recipients Important Information For Legal Immigrants
- FS 18 MULTI (9/99) - Important Information
- FS 20 (8/00) - You Do Not Owe Anything For Receiving Food Stamp Benefits
- FS 21 (8/00) - Release Form
- FS 22 QR (12/06) - Applying For Food Stamp Benefits
- FS 23 QR (3/05) - Food Stamp Benefits How To Report Household Changes
- FS 25 (3/04) - Food Stamp Program QC Regulation Interpretation Request
- FS 26 (12/09) - Food Stamp Program Qualifying Drug Felon Addendum
- FS 28 Coversheet (10/08) - Food Stamp Program Restricted Account Coversheet - Important To Know
- FS 28A (10/08) - Food Stamp Program Restricted Account Agreement Part A
- FS 28B (10/08) - Food Stamp Program Restricted Account Agreement Part B
- FS 29 (10/11) - CalFresh Recertification Appointment Letter
- FS 31 ENG/SP (2/09) - Notice To All Food Stamp Recipients Important - Please Read - Things You Need To Know
G Forms
- GE 1 (7/12) - IHSS General Exception Approval - Applicant Provider
- GE 2 (7/12) - IHSS General Exception Denial - Applicant Provider
- GE 3 (7/12) - IHSS General Exception Acknowledgement Of Appeal
- GE 4 (7/12) - IHSS General Exception Notice Of Late Appeal
- GE 5 (7/12) - IHSS General Exception Incompelte Request
- GE 6 (7/12) - IHSS General Exception Case Closure - Applicant Provider
- GEN 727B (7/12) - County Forms Order, with Instructions Do NOT download this file to your computer if you want to use it to order online - open the file within your web browser. You should have the latest version of Adobe PDF Reader installed on your computer to use this form online.
- GEN 1031 (4/13) - Annual County Training Plan
- GEN 1179 (9/12) - Complaint of Discrimination
- GEN 1187 (3/00) - Standard Agreement (Original Grant)
- GEN 1187A (3/00) - Standard Agreement (Amended Grant)