Follow the instructions listed there to download or print for your immediate use. If you experience any difficulties downloading, or encounter any dead links, please contact us.

Language Preference Forms
These forms can be used to capture information about the primary language spoken and read by applicants/recipients. The forms are from a variety of sources and contain different information. If you have any questions about the source of the forms or the design of the forms, contact your county liaison at the Civil Rights Unit.

Butte County
Tulare County
Sonoma County
Mendocino County
Advocates` Suggested Form

Other Suggested Forms Used by Counties
These represent some forms used currently by San Joaquin County:

Ventura County's Cultural Competence Plan

Civil Rights Posters

Posters on nondiscrimination must be displayed by county welfare departments in all public waiting rooms and reception areas (Div. 21-107.211). CDSS ACIN 31-05 (June 15, 2005) explains how to order the CDSS nondiscrimination poster, “Equal Under the Law”, Pub 86.

The USDA nondiscrimination poster, “And Justice for All,” Form AD-475B, must be displayed in all Food Stamps certification and issuance offices.

To order the Pub 86 and the Form AD-475B, contact the CDSS Warehouse to order these required posters.

Language Translation Services

Portable Document Format (PDF) files of CDSS forms and publications are available in English Forms and Publications.

They are also available in formats  Translated Forms and Publications,
then scroll down to find the appropriate language.

For an entire list of translated formats, go to CDSS Forms and Messages .

I Speak Cards

These cards can be used to help an individual obtain interpretive services. Check on the language to download and print out. Insert the name of the individual on the blank line on both the English and the non-English language statements. Cut along the border lines, place back-to-back with adhesive (glue or paste), and laminate the card.

Contact Us

Civil Rights Unit
P.O Box 944243, MS 9-7-041
Sacramento, CA  94244-2430
Phone:  (916) 654-2107
Toll free:  1-866-741-6241

County Point of Contact
County Civil Rights Coordinators