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