2013 Notice Of Forms Changes
13-153
CF 10 (12/13) Dependent Care Cost Affidavit
13-152
LIC 184D (12/13) Notification Of Incomplete Application (NOIA) Child Care Centers - 30-Day NOIA
13-151
LIC 184C (12/13) Notification Of Incomplete Application (NOIA) Child Care Centers - Pre-30-Day NOIA
13-150
LIC 184B (12/13) Notification Of Incomplete Application - Family Child Care Home
13-149
KG 2A (3/01) Rights, Responsibilities and Other Important Information for Kin-GAP Program -- Obsolete
13-148
WTW 39 (12/13) Assembly Bill (AB) 74 County Welfare Department (CWD) Expanded Subsidized Employment (ESE) Plan
13-147
AR 2 (11/13), AR 2 SAR (11/13), SAR 2 (11/13)
13-146
EBT 2259 (11/13) Report Of Electronic Theft Of Cash Aid And Instructions
13-145
PUB 429 (11/13) English and Spanish - 2013 Earned Income Tax Credit It's Your Money You Earned It - Now Claim It And Save It
13-144
PUB 428 (11/13) English and Spanish - It's Your Money Claim It & Save It File For Your 2013 Earned Income Tax Credit
13-142
AD 551A (11/13) Notification Of Procedure In Lieu Of Signing Relinquishment, Waiver or Denial
13-141
TEMP 42-769 (8/11) School Bonus
13-140
FS 12 (5/05) ENG/SP Notice To All Food Stamp Households With Elderly And/Or Disabled Members
13-139
SAWS 1 (8/13) English and Spanish - Initial Application For CalFresh, Cash Aid, And/Or Medi-Cal/Health Care Programs
13-138
FS 22 QR (10/13) Applying For Food Stamp Benefits
13-137
SAWS 2A QR (9/11) English and Spanish - Rights, Responsibilities And Other Important Information
13-136
NA 960Y SAR (9/13) Notice Of Action - Stop Aid; Report Incomplete
13-135
NA 960X SAR (9/13) Notice Of Action - Stop Aid; Report Not Received
13-134
CF 377.2A (10/13) CalFresh Notice Of Expiration Of Certification For Households In Which All Adults Are Elderly or Disabled
13-133
CF 377.2 (10/13) CalFresh Notice Of Expiration Of Certification
13-132
AD 590B (9/13) Waiver Of Right To Further Notice Of Adoption Planning (Biological/Presumed Father In Or Out Of California) Indian Child
13-131
SAWS 2 PLUS (9/13) English and Spanish - Application For CalFresh, Cash Aid, And/Or Medi-Cal/Health Care Programs
13-130E
M44-350K (8/13) EBT Replacement Denial
M44-350L (8/13) Notice Of Overpayment
TEMP WI 10072 (8/13) EBT Replacement Approval
TEMP WI 10072A (8/13) EBT Replacement Review
13-130
M44-350L (8/13) Notice Of Overpayment
M44-350M (8/13) EBT Replacement Denial
TEMP WI 10072 (8/13) EBT Replacement Approval
TEMP WI 10072A (8/13) EBT Replacement Review
13-129
CF 11A (9/13) English and Spanish Notice To All CalFresh Recipients
13-128
CF 11 (9/13) English and Spanish Notice To All CalFresh Recipients
13-127
DFA 285-A1 (2/13) English and Spanish - CalFresh Benefits
13-126
CW 2212 (9/13) The Rules For Your CalWORKs Case Have Changed Annual Reporting To Semi-Annual Reporting
13-125
CW 2211 (9/13) Your CalWORKs Reporting Rules Have Changed Semi-Annual Reporting To Annual Reporting
13-124
TEMP SAR 1 (9/13) Important Please Read New Reporting Requirements For Cash Aid And CalFresh
13-123
SAR 7A (9/13) How To Fill Out Your SAR 7 Eligibility Status Report For Cash Aid And CalFresh (formerly known as Food Stamp) Benefits
13-122
SAR 7 (8/13) SAR 7 Eligibility Status Report
13-121
SAR 2 (9/13) Reporting Changes For Cash Aid And CalFresh
13-120
AR 2 SAR (9/13) Reporting Changes For CalWORKs And CalFresh
13-119
AD 929A (7/13) - Waiver Of Right To Revoke Relinquishment Agency Adoption Program
13-118
AD 508 (7/13) - Rescission Request/Rescission Of Relinquishment
13-117
WTW 39 (9/13) Assembly Bill (AB) 74 County Welfare Department (CWD) Expanded Subsidized Employment (ESE) Plan
13-116
AD 512 (7/13) - Psychosocial And Medical History Of Child
13-115
WTW 17 (9/13) Waiver Of CalWORKs Learning Disabilities Screening And/Or Evaluation
13-114
WTW 15 (9/13) Simplified CalFresh Program Unpaid Work Expereicne (WEX) And Unpaid Community Service Hours Worksheet
13-113
WTW 5 (9/13) Welfare-To-Work Program Notice
13-112
TEMP 2215 (7/02) English and Spanish - Electronic Benefit Transfer (EBT) Important Information
13-111
Messages in ACL 13-80
13-110
CF 215 (8/13) CalFresh Notification of Inter-County Transfer
13-109
FS 22 QR (12/06) English and Spanish - Applying For Food Stamp Benefits
13-108
PUB 339 (7/13) Foster Care Ombudsman Brochure
13-107
SOC 412 (8/02) English and Spanish - IHSS Employee's Claim For Workers' Compensation Benefits
13-105
CF 285 (9/13) Application For CalFresh Benefits
13-104
CF 388 (8/13) CalFresh Notice Of Restoration Approval
13-103
CF 377.6 (8/13) Information/Verification Needed
13-102
CF 286 SAR (8/13) CalFresh Budget Worksheet/Semi-Annual Reporting Households
13-101
CF 23 CR (9/13) CalFresh Benefits How To Report Housdhold Changes
13-100
TEMP 2259 (12/12) English and Spanish - Report Of Electronic Theft Of Cash Aid
13-099
AD 90 (6/13) Supporting Information For Issuance Of California Department Of Social Services Acknowledgement And Confirmation Of Receipt Of Child Freeing Documents
13-098
EBT 2259 (8/13) Report Of Electronic Theft Of Cash Aid And Instructions
13-097
CF 377.5 SAR (9/13) CalFresh Mid-Certification Period Status Report
13-096
PUB 415 (1/06) California Loves Kids - Obsolete
13-095
M40-105C (7/13) Notice Of Action - Immunizations
M40-105E (7/13) Notice Of Action - School Attendance
13-094
GE 1 through GE 6 (7/12) - All languages
13-093
SOC 310 (1/03) English and Spanish - Statement Of Facts For In-Home Supportive Services
13-092
SOC 884 (8/12) County CMIPS II User Request Form Add/Modify User
13-091
SOC 882 (8/12) County CMIPS II User ID Confirmation CDSS Copy
13-090
SOC 829 (9/12) IHSS Provider Direct Deposit Enrollment/Change/Cancellation Form
13-089
SOC 872 (7/12) Statement Of Facts (SOF) Preparation Checklist IHSS Program Caregiver Background Check Bureau (CBCB), General Exception Unit (GEU)
13-088
SOC 871 (7/12) Statement Of Facts (SOF) Summary Sheet IHSS Program Caregiver Background Check Bureau (CBCB), General Exception Unit (GEU)
13-087
SOC 865 (7/12) English and Spanish IHSS Request For Applicant Provider Reference
13-086
DFA 285-A3 QR (6/13) CalFresh Benefits Your Rights And Responsibilities
13-085
NA 1275 (7/13) Electronic Notification Cancellation Notice
13-084
NA 1274 (7/13) Electronic Notification Notice
13-083
NA 1273 (7/13) Electronic Notification Agreement
13-082
PUB 132 (5/05) California Child Abuse And Neglect Reporting Law - Obsolete
PUB 132 (6/2012) The California Child Abuse And Neglect Reporting Law
13-081
PUB 129 (12/06) Child Abuse Reporting And You - Obsolete
PUB 270 (12/05) Never Shake A Baby - Medical Brochure - Obsolete
13-080
EFA 15 (5/13) English and Spanish Alternate Pick-Up Request Form Emergency Food Assistance Program (EFAP) 2013 Income Guidelines
13-079
EFA 14 (5/13) English and Spanish Emergency Food Assistance Program (EFAP) 2013 Income Guidelines
13-078
SOC 834 (3/13) English and Spanish Request For Grievance Hearing
13-077
WTW 38 (6/13) Welfare-To-Work 24-Month Time Clock Notice
13-076
SOC 832 (1/13) English and Spanish Notice Of Child Abuse Central Index Listing
13-075
CF 377.2A2 (6/13) Client Survey
13-074
CF 377.2A1 (6/13) Important Information
13-073
CF 377.2A (7/13) CalFresh Notice Of Expiration Of Certification For Households In Which All Adults Are Elderly Or Disabled
13-072
NA BACK 9 (4/13) Your Hearing Rights
13-071
CF 377.6 (6/13) Notice Of Action Information/Verification Needed
13-070
CF 377.5 (6/13) CalFresh Mid-Certification Period Status Report
13-069
CF 377.4 SAR (6/13) CalFresh Notice Of Change For Semi-Annual Reporting Households
13-068
CF 377.2 (6/13) CalFresh Notice Of Expiration Of Certification
13-067
CF 285 SAR (6/13) CalFresh Budget Worksheet/Semi-Annual Reporting Households
13-066
CF 32 (6/13) CalFresh Request For Contact
13-065
CF 29 (6/13) CalFresh Recertification Appointment Letter
13-064
CF 23 SAR (6/13) CalFresh Benefits How To Report Household Changes
13-063
SOC 449 (6/13) In-Home Supportive Services Program Public Authority/Nonprofit Consortium Rate
13-062
PUB 367 (4/13) English and Spanish Reach For Your Dreams With Cal-Learn Brochures
13-060
TEMP 44-111A (4/13) Income Disregards - Change
13-061
SOC 885 (6/13) In-Home Supportive Services (IHSS) Program Notice Of Denial Of Request For In-Home Reassessment Based On State Law Change
13-059
NA 532 (4/13) Notice Of Action - Continuation Page - 48-Month Time Limit Discontinue
13-058
NA 531 (4/13) Notice Of Action - Continuation Page - 48-Month Time Limit - Includes Budget
13-057
NA 300 (4/13) Notice Of Action - Continuation Page - Recipient Financial Eligibility Test
13-056
NA 281B (5/13) Notice Of Action - Continuation Page - Underpayment Computations On Or After 10/1/2013
13-055
NA 274G (5/13) Notice Of Action - Continuation Page - Overpayment Computations For 10/1/2013
13-054
NA 271 (4/13) Notice Of Action - Continuation Page - Family Income Computations - Cash Aid
13-053
NA 200 (4/13) Notice Of Action - Multipurpose
13-052
CW 2166 (5/13) Work Pays Notice - Multilingual
13-051
CW 30 (4/13) CalWORKs Budget Worksheet
13-050
TEMP 2252 (5/13) State Law Changes The CalWORKs Earned Income Disregard
13-049
LIC 406 (5/13) Client/Resident Cash Sheet
13-048
FA 10B (4/13) Fiscal Audit Summary Of Exit Conference Pont Sheet(s)1 No. __
13-047
FA 10A (5/13) Fiscal Audit Summary of Exit Conference
13-046
FA 7 (4/13) Fiscal Audit Entrance Conference Questionnaire
13-045
SAWS 2A SAR (4/13) Rights, Responsibilities And Other Important Information
13-043
SAR 73 (3/13) Senior Parent Semi-Annual Income Report
13-042
SAR 72 (3/13) Sponsor's Semi-Annual Income And Resources Report (Supplement To The SAR 7)
13-041
SAR 23 (3/13) Senior Parent Statement Of Facts (Supplement to The SAWS 2)
13-040
SAR 22 (3/13) Sponsored Noncitizens Applying For Or Receiving Cash Aid And/Or CalFresh
13-039
SAR 7 Addendum (4/13) Instructions And Penalties SAR 7 Eligibility Status Report For Cash Aid And CalFresh
13-038
SAR 3 (4/13) Mid-Period Status Report For Cash Aid And CalFresh
13-037
CW 2103 (2/13) Reminder For Teens Turning 18 Years Old
13-036
CW 31 SAR (4/13) Receipt For Documents
13-035
CW 29 (1/13) Applicant Test - Intake Financial Test
13-034
CW 25A (2/13) Payee Agreement For Minor Parent
13-033
CW 8A (4/13) Statement Of Facts To Add A Child Under Age 16
13-032
CW 8 (3/13) Statement Of Facts For An Additional Person
13-031
SOC 449 (4/13) IHSS Public Authority/Nonprofit Consortium Rate
13-030
CF 27 (2/13) Non-Assistance CalFresh (NACF) Household Recertification Form
13-029
FS 27 (3/10) Non-Assistance Food Stamps (NAFS) Household Recertification Form
13-028
AD 501 (4/13) Relinquishment In or Out-of-County (Birth Mother/Presumed Father In California)
13-027
AAP 7 (3/13) Adoption Assistance Program Statement Of Acknowledgment
13-026
SOC 824 (2/13) IHSS Quality Assurance/Quality Improvement QA/QI Quarterly Activities Report
13-025
DFA 285-A3 QR (1/13) English and Spanish CalFresh Benefits Your Rights And Responsibilities
13-024
AD 925 (9/12) Independent Adoption Placement Agreement (Indian Child)
13-023
List Of Obsoleted Forms - TEMP CL 1, TEMP CL 2, TEMP CL 4, TEMP CL 8, TEMP CL 10, TEMP M42-769, TEMP WTW 5, TEMP CW 2186C, TEMP NA BACK 9
13-022
List Of Obsoleted Forms - FS 11B, FS 11C, FS 17, FS 25, FS 31, NA 1215, NA 1216, QR 25A, TEMP 2193, TEMP 2193A, TEMP 2224, TEMP 2225, TEMP 2227, TEMP 2230
13-021
AD 508 (4/13) Request For Rescission Of Relinquishment
13-020
CW 2208 (2/13) Your Welfare To Work (WTW) 24-Month Time Clock
13-019
CF 377.1 (2/13) Notice Of Approval For CalFresh Benefits
13-018
CF 1 (1/13) Notice To All CalFresh Recipients Important - Please Read
13-017
Notice Of Action - NA 791 (10/12) Required Form - Substitute Permitted AAP - Approval/Change
13-016
TEMP AR 1 (2/13) Important Information - New Reporting Requirements For CalWORKs and CalFresh
13-015
AR 3 (12/12) Mid-Year Status Report For CalWORKs And CalFresh
13-014
AR 2 (12/12) Reporting Changes For CalWORKs And CalFresh
13-013
PUB 269 (2/13) California Child Passenger Safey Law
13-012
PUB 403, PUB 403A, PUB 403B, PUB 403C (1/13) EBT Farmers Market Posters
13-011
SOC 2244 (1/13) English and Spanish - IHSS Providers Notice Of New Timesheets
13-010
SOC 2243 (1/13) English and Spanish - IHSS Recipients Notice Of New Timesheets
13-009
DFA 377.1 (1/13) English and Spanish Notice Of Approval Of CalFresh Benefits
13-007
NA 1250 (11/12) Notice Of Action - IHSS Approval
NA 1253 (11/12) Notice Of Action - IHSS Change
13-006
DFA 377.1 (12/12) Notice Of Approval Of CalFresh Benefits
13-005
TEMP 2259 (12/12) Report Of Electronic Theft Of Cash Aid
13-004
CW 2186B (12/12) CalWORKs Exemption Determination
13-003
CW 2186A (12/12) CalWORKs Exemption Request Form
13-002
CW 2206 (1/13) Young Child Exemption Ends December 31, 2012 New Rules For CalWORKs Welfare-To-Work Activities
13-001
WTW 2 (12/12) Welfare-To-Work Plan Activity Assignment