2006 Notice Of Form Changes
- 06-164
QR 285B (11/06) English Only - Food Stamp Budget Worksheet - 06-163
DFA 285D (11/06) English Only - Food Stamp Budget Worksheet - Special Medical/Shelter Deductions - 06-162
DFA 285B (11/06) English Only - Food Stamp Budget Worksheet/Change Reporting Household - 06-161
LIC 9224 (12/06) - Acknowledgment of Receipt of Licensing Reports - 06-160
PUB 393 (12/06) - Child Care Center - Notification of Parents' Rights Poster - 06-159
PUB 394 (12/06) - Family Child Care Home - Notification of Parents' Rights Poster - 06-158
LIC 165 (10/06) - Board Of Directors Statement - Crisis Nurseries - 06-157
LIC 9188 (12/06) - Criminal Record Exemption Transfer Request - 06-156
LIC 9182 (12/06) - Criminal Background Clearence Transfer Request - 06-154
PUB 414 (10/06) - Crisis Nurseries Board Of Directors Booklet - 06-151
LIC 995A (12/06) - Family Child Care Homes Notification of Parent's Rights - 06-150
LIC 995 (12/06)- Child Care Center - Notification of Parents' Rights - 06-149
LIC 9219A English and Spanish (10/06) - Crisis Nursery Monthly Report - 06-148
LIC 9219 English and Spanish (10/06) - Crisis Nursery Monthly Report - 06-146
CA 800 FC1B (10/06) - Foster Care Out-Of-State Facility Report - 06-144
CA 800 FC FED PIA (9/06) Foster Care Placement Information Addendum (PIA) Federal - Person Count - 06-143
CA 800 STEP (9/06) - Summary Report Of Assistance Expenditures, Supportive Transitional Emancipation Program (STEP) & The Transitional Housing Plus Program (THP-PLUS), Federal - 06-142
CA 800 CERT (9/06) Expenditure Certification for the County Welfare Department Assistance Claim Expenditures - 06-141
CA 800A FED (9/06) - Summary Report Of Assistance Expenditures, Adoption Assistance, Emergency Assistance-General Assistance, Emergency Assistance-Foster Care, Refugee Cash Assistance, Federal - 06-138
CW 5 (7/01) English and Spanish - Veterans Benefits Verification and Referral - 06-137
AD 4311 (9/00) Information On American Indian Child (Adoption Program) - 06-136
QR 3 (7/06) English and Spanish - Mid-Quarter Status Report - 06-135
TEMP 2227 ENG/SP (9/06)- Important - As of November 1, 2006 - 06-134
TEMP 2225 ENG/SP (9/06) - Notice To All Food Stamp Recipients - 06-133
NA 1217 (9/06) - CAPI Notice Of Overpyament - 06-132
NA 1218 (9/06) - CAPI Notice Of Underpayment - 06-131
AD 899A (3/06) ENG/SP - Statement Of Understanding - Mother Or A Presumed Father Of An Indian Child Who Is Detained, A Juvenile Court Dependent In Out-Of-Home Care, Or The Ward Of A Legal Guardian - 06-130
QR 285B (9/06) - Food Stamp Budget Worksheet - 06-128
DFA 285-A3 QR ENG/SP (5/06) - Food Stamp Benefits Your Rights And Responsibilities - 06-127
FS 22 QR ENG/SP (7/06) - Applying For Food Stamp Benefits - 06-126
DFA 377.5 ENG/SP (8/06) - Food Stamp Household Change Report (DFA 377.5) - 06-125
PUB 13 (8/06) - Your Rights Pamphlet (Requires 8 1/2" x 14" paper printed landscape) and PUB 13 - Your Rights Under California Welfare Programs (Large Print also) - 06-124
QR 285B (8/06) - Food Stamp Budget Worksheet - 06-123
FS 11 ENG/SP (8/06) - Notice To All Food Stamp Recipients Important - Please Read - 06-122
LIC 812 (8/06) - Detail Supportive Information - 06-121
LIC 811 (8/06) - Confidential Names - 06-120
LIC 857 (8/06) - Children's Records Review (Child Care Center) - 06-119
LIc 859 (8/06) - Review of Staff/Volunteer Records - 06-118
LIC 9102 (8/06) - Advisory Notes - 06-117
LIC 995A (8/06) - Family Child Care Home Notification Of Parents' Rights - 06-116
LIC 624B (8/06) Unusual Incident/Injury Report - Family Child Care Homes - 06-115
QR 285B (7/06) Food Stamp Budget Worksheet - 06-114
DFA 285D (7/06) - Food Stamp Budget Worksheet - Special Medical/Shelter Deductions - 06-113
DFA 285B (7/06) - Food Stamp Budget Worksheet/Change Reporting Housholds - 06-112
TEMP 2227 ENG/SP (7/06) - Important - Figuring Food Stamp Benefits - 06-111
TEMP 2225 ENG/SP (7/06) - Notice To All Food Stamp Recipients - 06-110
SOC 825 (6/06) English and Spanish - Protective Supervision 24-Hours-A-Day Coverage Plan - 06-109
AD 885 (3/06) English and Spanish - Statement Of Understanding - Mother Or Presumed Father Of Child Who Is Not Detained, A Juvenile Court Dependent In Out-Of-Home Care, Or The Ward Of A Legal Guardian - 06-108
SAWS 2A QR (5/06) English and Spanish - Rights, Responsibilities and Other Important Information - 06-107
TEMP 2226 (7/06) ENG/SP - New Rules For Homeless Assistance For Persons Eligible For Cash Aid - 06-106
AD 885C (3/06) - Statement Of Understanding - Alleged Natural Father Of Child Who Is Not Detained, A Juvenile Court Dependent In Out-Of-Home Care, Or The Ward Of A Legal Guardian - 06-105
FS 24 (7/06) - Food Stamp Program Request For Regulation Interpretation - 06-104
PUB 220 (5/06) - California Directory Of Resource Information For People Who Are Deaf And Hard Of Hearing - 06-103
AD 900B (3/06) - Statement Of Understanding - Alleged Natural Father Of INDIAN Child - 06-102
AD 90 (7/06) - Supporting Information For Issuance Of California Department Of Social Services Acknowledgement And Confirmation Of Receipt Of Relinquishment Documents - 06-101
SOC 332 (6/06) - In-Home Suppportive Services Recipient/Employer Responsibility Checklist - 06-100
AD 885D English & Spanish (3/06) - Statement Of Understanding - Alleged Natural Father Of A Child Who Is Detained, A Juvenile Court Dependent In Out-Of-Home Care, Or The Ward Of A Legal Guardian - 06-099
DFA 358S (7/06) - Food Stamp Program Participants By Ethnic Group/State Only - 06-098
DFA 358F (7/06) - Food Stamp Program Participants By Ethnic Group/Federal-Only And Continued Households - 06-097
AD 887B (3/06) Spanish - Statement Of Understanding Independent Adoptions Program - Alleged Natural Father - 06-096
AD 900A (3/06) English & Spanish - Statement Of Understanding - Independent Adoptions Program - Parent Who Did Not Give Physical Custody (Non-Custodial) Of The INDIAN Child To The Petitioner(s) - 06-095
AD 899D (3/06) English & Spanish - Statement Of Understanding - Alleged Natural Father Of An INDIAN Child Who Is Detained, A Juvenile Court Dependent In Out-Of-Home Care, Or The Ward Of A Legal Guardian - 06-094
AD 867 (3/06) English & Spanish - Relinquishment Of An Indian Child - Out-Of-State (Presumed Father Denies He Is The Birth Father) - 06-093
AD 864 (3/06) English & Spanish - Relinquishment Of An Indian Child - In/Out Of County (Birth Mother/Presumed Father In California) - 06-092
AD 868 (3/06) English & Spanish - Relinquishment Of An Indian Child (Alleged Natural Father In California) - In/Out Of County - 06-091
AD 4328 (3/06) Spanish - Authorization For Release Of Personal Items - 06-090
CANCELLED - 06-089
AD 885A (3/06) English & Spanish - Statement Of Understanding - Mother Or A Presumed Father Of A Child Who Is Detained, A Juvenile Court Dependent In Out-Of-Home Care, Or The Ward Of A Legal Guardian - 06-087
AD 862 (3/06) English & Spanish - Relinquishment Of An Indian Child - Out-Of-State (Alleged Natural Father) - 06-086
AD 583 (3/06) ENG/SP - Relinquishment In Or Out-Of-County (Presumed Father Denies He Is The Birth Father In California) - 06-085
AD 4339 (3/06) ENG/SP - Relinquishment - Out Of State (Birth Mother/Presumed Father) - 06-084
AD 899 (3/06) ENG/SP - Statement Of Understanding - Mother Or A Presumed Father Of The INDIAN Child Who Is Not Detained, A Juvenile Court Dependent In Out-Of-Home Care, Or A Ward Of A Legal Custodian - 06-083
AD 866 ENG/SP (3/06) - Relinquishment Of An Indian Child In Or Out-Of-County (Presumed Father Denies He Is The Birth Father In California) - 06-082
AD 588 (3/06) ENG/SP - Denial Of Paternity By Alleged Natural Father In Or Out Of California - 06-081
AD 594 (3/06) ENG/SP - Consent For Alleged Father In/Outside California - 06-080
TEMP NA 1232 (3/06) English and Spanish - Food Stamp Notice Of Action EBT Account - 06-079
TEMP 2193A (5/06) ENG/SP - Notice To All Food Stamp Recipients - Important - Please Read - 06-078
TEMP 2193 (5/06) ENG/SP - Notice To All Food Stamp Recipients - Important - Please Read - 06-077
AD 900 English & Spanish (3/06) - Statement Of Understanding - Parent Who Gave Physical Custody (Custodial) Of The Indian Child To The Petitioner(s) - 06-076
AD 887A English & Spanish (3/06) - Statement Of Understanding - Parent Who Did Not Give Physical Custody Of Child To The Petitioner(s) - 06-074
AD 863 English & Spanish (3/06) - Relinquishment Of An Indian Child - Out-of-State (Birth Mother/Presumed Father) - 06-073
AD 2B English & Spanish (3/06) - Stepparent Adoption - 06-072
AD 586 ENG/SP (3/06) Relinquishment - In Or Out-Of-County (Alleged Natural Father In California - 06-071
AD 904 English & Spanish (3/06) Consent For Contact - 06-070
AD 20B ENG/SP (3/06) Refusal To Consent - Alleged Father - 06-069
AD 1C ENG/SP (3/06) Consent by Parents Outside California - 06-068
LIC 279A Spanish (11/05) Application Instructions For A Family Child Care Home License - 06-067
WTW 16A (6/06) Examples Of Family Income (Region 1) WTW 16B (6/06) Examples Of Family Income (Region 2) - 06-066
LIC 9210 (5/06) Quarterly County Exemption Report - 06-065
LIC 421 (5/06) Civil Penalty Assessment LIC 421B (5/06) Civil Penalty Assessment - Immediate - 06-064
AD 887 English & Spanish (3/06) Statement Of Understanding Independent Adoptions Program - Parent Who Gave Physical Custody (Custodial Parent) Of The Child To The Petitioner(s) - 06-063
ICPC 100E (8/93) Interstate Compact Placement Request For Private Placements - 06-061
AD 908A (3/06) Spanish - Adoptions Information Act Statement - 06-060
SAWS 2 (1/06) English and Spanish - Statement Of Facts For Cash Aid, Food Stamps, And Medi-Cal 34-County Medical Services Program (CMSP) - 06-059
CCP 7 (2/05) English and Spanish - CalWORKs Stage One Child Care Request Form And Payment Rules - 06-058
PUB 13 (11/05) - Your Rights Under California Welfare Programs (Large Print also) - 06-057
WTW 3 English & Spanish (2/04) - Welfare to Work Plan Activity Assignment Change; WTW 21 English & Spanish (1/02) - Notice Of Adjustment Of The CalWORKs 18- or 24-Month Welfare-To-work Time Clock - 06-056
TEMP NA 1234 English & Spanish (1/03) - No Adjustment To WtW Time Limit Based On Learning Disabilities; TEMP NA 1235 English & Spanish (9/02) - Adjustment To WtW Time Limit Based On Learning Disabilities - 06-055
SOC 294A (3/02) - IHSS Income Eligibility - Adult; SOC 294C (11/99) - IHSS Income Eligibility - Child; SOC 312 (5/00) - In-Home Supportive Services Special Pre-Authorized Transactions - 06-054
GEN 1031 (4/06) - Annual County Training Plan - 06-053
AD 924 English & Spanish (3/06) -Independent Adoption Placement Agreement - 06-052
AD 904A English & Spanish (3/06) -Waiver Of Rights To Confidentiality For Siblings - 06-051
WTW 20 English & Spanish (12/05) -Permission To Release Learning Disabilities Information - 06-050E
Errata To WTW 17 English & Spanish (12/05) - Waiver Of CalWORKs Learning Disabilities Screening And/Or Evaluation - 06-050
WTW 17 English & Spanish (12/05) - Waiver Of CalWORKs Learning Disabilities Screening And/Or Evaluation - 06-049E
Errata To WTW 16 English & Spanish (12/05) - Grant-Based On The Job Training Participation: Voluntary Consent Form - 06-049
WTW 16 English & Spanish (12/05) - Grant-Based On The Job Training Participation: Voluntary Consent Form - 06-048
WTW 15 (12/05) - Simplified Food Stamp Program Unpaid Work Experience - 06-047E
Errata To WTW 2 English & Spanish (12/05) - Welfare-To-Work Plan Activity Agreement - 06-047
WTW 2 English & Spanish (12/05) - Welfare-To-Work Plan Activity Agreement - 06-046E
Errata To WTW 1 English & Spanish (12/05) - Welfare-To-Work Plan Rights And Responsibilities - 06-046
WTW 1 English & Spanish (12/05) - Welfare-To-Work Plan Rights And Responsibilities - 06-045E
Errata to CW 215 (12/05) - Notification Of Intercounty Transfer; and CW 2186A (12/05) - CalWORKs Time Limit And Welfare-To-Work Participation Exemption Request Form - 06-045
CW 215 (12/05) - Notification Of Intercounty Transfer; and CW 2186A (12/05) - CalWORKs Time Limit And Welfare-To-Work Participation Exemption Request Form - 06-044
CA 237 FC (3/06) - Aid To Families With Dependent Children (AFDC) Foster Care (FC) Caseload Movement And Expenditure Report - 06-043
STAT 47 (10/06) - Food Stamp Program Work Registrant, Able-Bodied Adults Without Dependents (ABAWD), And Food Stamp Employment And Training (FSET) Program Caseload Report - 06-042
STAT 48 (10/06) - Annual Work Registrant And Food Stamp Employment And Training (FSET) Program Caseload Report - 06-041
AD 20 ENG/SP (3/06) - Refusal To Give Consent To Adoption - 06-040
AD 166 ENG/SP (3/06) - Consent For Presumed Father Outside California - 06-039
SOC 821 (3/06) - Assessment Of Need For Protective Supervision - 06-038
LIC 9142A (3/06) - Roster Of Participants - For Vendor Use Only - 06-037
AD 594 (3/06) - Consent For Alleged Father In/Outside California - 06-036
WTW 30 (3/06) - County TANF Work Participation Rates - 06-035
AD 908A (3/06) - Adoptions Information Act Statement - 06-034
AD 4328 (3/06) - Authorization For Release Of Personal Items - 06-033
AD 887B (3/06) - Statement Of Understanding Alleged Natural Father - 06-032
AD 887A (3/06) - Statement Of Understanding - Parent Who Did Not Give Physical Custody Of Child To The Petitioner(s) - 06-031
AD 591 ENG/SP (12/05) - Relinquishment Out-of-State (Alleged Natural Father) - 06-030
AD 501A ENG/SP (12/05) - Relinquishment Out-of-State (Birth Mother/Presumed Father) - 06-029
AD 590 ENG/SP (12/05) - Waiver Of Right To Further Notice Of Adoption Planning (Alleged Natural Father In Or Out Of California) - 06-028
PUB 370 English & Spanish (10/05) - Public Benefits For Asylees In California - 06-027
CW 51 English & Spanish (11/04) - Child Support - Good Cause - 06-026
VARIOUS FORMS MADE MASTER ONLY - 06-025
VARIOUS FORMS MADE MASTER ONLY - 06-024
VARIOUS FORMS MADE MASTER ONLY - 06-023
SR 8 (1/06)- Financial Audit Report Transmittal - 06-022
AD 590A Spanish (12/05)- Waiver Of Right To Further Notice Of Adoption Planning (Presumed Father In Or Out Of California - 06-021E
CCP 2145 English & Spanish (5/04)- CalWORKs Child Care Reimbursement Report - 06-021
CCP 2145 English & Spanish (10/05)- CalWORKs Child Care Reimbursement Report - 06-020
LIC 9040 English & Spanish (10/05)- Child Care Facility Roster - 06-019
SSGP 45 (1/06)- State Supplemental Grant Program Handout - 06-018
SAWS 2A QR English & Spanish (11/05)- Rights And Responsibilities And Other Important Information - 06-017
LIC 421B (1/06)- Civil Penalty Assessment (Criminal Background Clearance) - 06-016
SOC 822 (1/06)- CAPI Notification Of Inter-County Transfer - 06-015
PUB 341 (9/05)- Adoptions Services Bureau Career Opportunities - 06-013
AD 584 ENG/SP (12/05)- Relinquishment - Out-of-State (Presumed Father Denies He Is The Birth Father) - 06-012
PUB 394 SP (12/05)- Notification Of Parents' Rights Poster - 06-011
SR 10 (2/06)- Certification Of Audited Cost Data - 06-010
LIC 9212 SP (10/05)- Consumer Awareness Information - Family Child Care - 06-009
SR 9 (2/06)- Federal Revenue Certification - 06-008
PUB 56 SP (3/05)- In-Home Supportive Services Program - 06-007
PUB 56 (3/05)- In-Home Supportive Services Program - 06-006
PUB 104 Spanish (4/05)- In-Home Supportive Services Individual Provider Benefits & Services Information - 06-005
PUB 104 (4/05)- In-Home Supportive Services Individual Provider Benefits & Services Information - 06-004
PUB 190 (3/05)- How To Hire & Supervisr Your In-Home Supportive Services Provider - 06-003
PUB 190 Spanish (3/05)- How To Hire & Supervise Your In-Home Supportive Services Provider - 06-002
DFA 377.4 QR English & Spanish (1/04)- Food Stamp Notice Of Change For Change Reporting Household - 06-001
TLR 1 English & Spanish (10/05)- Trustline Registry - Subsidized Application
