Dpss income verification form

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___ (Case Number) Case Name: (if different than payee) ___ ___ (Payee ID*) Type of account: (circle one) Checking Savings Address: Payee’s Social Security Number/Taxpayer ID#: City, State and ZIP Code: Telephone Number: Payee Certification This authorizes and instructs the Department of Public Social Services (DPSS) to deposit cash benefits to which I am entitled directly into the account at the depository institution designated in Section 2 below. I understand that DPSS’ obligation is...

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  • Do military members have to pay any fee for leave or fiancee forms?

    NOOOOOOO. You are talking to a military romance scammer. I received an email from the US Army that directly answers your question that is pasted below please keep reading.I believe you are the victim of a military Romance Scam whereas the person you are talking to is a foreign national posing as an American Soldier claiming to be stationed overseas on a peacekeeping mission. That's the key to the scam they always claim to be on a peacekeeping mission.Part of their scam is saying that they have no access to their money that their mission is highly dangerous.If your boyfriend girlfriend/future husband/wife is asking you to do the following or has exhibited this behavior, it is a most likely a scam:Moves to private messaging site immediately after meeting you on Facebook or SnapChat or Instagram or some dating or social media site. Often times they delete the site you met them on right after they asked you to move to a more private messaging siteProfesses love to you very quickly & seems to quote poems and song lyrics along with using their own sort of broken language, as they profess their love and devotion quickly. They also showed concern for your health and love for your family.Promises marriage as soon as he/she gets to state for leave that they asked you to pay for.They Requests money (wire transfers) and Amazon, iTune ,Verizon, etc gift cards, for medicine, religious practices, and leaves to come home, internet access, complete job assignments, help sick friend, get him out of trouble, or anything that sounds fishy.The military does provide all the soldier needs including food medical Care and transportation for leave. Trust me, I lived it, you are probably being scammed. I am just trying to show you examples that you are most likely being connned.Below is an email response I received after I sent an inquiry to the US government when I discovered I was scammed. I received this wonderful response back with lots of useful links on how to find and report your scammer. And how to learn more about Romance Scams.Right now you can also copy the picture he gave you and do a google image search and you will hopefully see the pictures of the real person he is impersonating. this doesn't always work and take some digging. if you find the real person you can direct message them and alert them that their image is being used for scamming.Good Luck to you and I'm sorry this may be happening to you. please continue reading the government response I received below it's very informative.   You have contacted an email that is monitored by the U.S. Army Criminal Investigation Command. Unfortunately, this is a common concern. We assure you there is never any reason to send money to anyone claiming to be a Soldier online. If you have only spoken with this person online, it is likely they are not a U.S. Soldier at all. If this is a suspected imposter social media profile, we urge you to report it to that platform as soon as possible. Please continue reading for more resources and answers to other frequently asked questions:  How to report an imposter Facebook profile: Caution-https://www.facebook.com/help/16... < Caution-https://www.facebook.com/help/16... >   Answers to frequently asked questions:  - Soldiers and their loved ones are not charged money so that the Soldier can go on leave.  - Soldiers are not charged money for secure communications or leave.  - Soldiers do not need permission to get married.  - Soldiers emails are in this format: [email protected] < Caution-mailto: [email protected] > anything ending in .us or .com is not an official email account.  - Soldiers have medical insurance, which pays for their medical costs when treated at civilian health care facilities worldwide – family and friends do not need to pay their medical expenses.  - Military aircraft are not used to transport Privately Owned Vehicles.  - Army financial offices are not used to help Soldiers buy or sell items of any kind.  - Soldiers deployed to Combat Zones do not need to solicit money from the public to feed or house themselves or their troops.  - Deployed Soldiers do not find large unclaimed sums of money and need your help to get that money out of the country.  Anyone who tells you one of the above-listed conditions/circumstances is true is likely posing as a Soldier and trying to steal money from you.  We would urge you to immediately cease all contact with this individual.  For more information on avoiding online scams and to report this crime, please see the following sites and articles:   This article may help clarify some of the tricks social media scammers try to use to take advantage of people: Caution-https://www.army.mil/article/61432/< Caution-https://www.army.mil/article/61432/>   CID advises vigilance against 'romance scams,' scammers impersonating Soldiers  Caution-https://www.army.mil/article/180749 < Caution-https://www.army.mil/article/180749 >   FBI Internet Crime Complaint Center: Caution-http://www.ic3.gov/default.aspx< Caution-http://www.ic3.gov/default.aspx>   U.S. Army investigators warn public against romance scams: Caution-https://www.army.mil/article/130...< Caution-https://www.army.mil/article/130...>   DOD warns troops, families to be cybercrime smart -Caution-http://www.army.mil/article/1450...< Caution-http://www.army.mil/article/1450...>   Use caution with social networking  Caution-https://www.army.mil/article/146...< Caution-https://www.army.mil/article/146...>    Please see our frequently asked questions section under scams and legal issues. Caution-http://www.army.mil/faq/ < Caution-http://www.army.mil/faq/ > or visit Caution-http://www.cid.army.mil/ < Caution-http://www.cid.army.mil/ >.  The challenge with most scams is determining if an individual is a legitimate member of the US Army. Based on the Privacy Act of 1974, we cannot provide this information. If concerned about a scam you may contact the Better Business Bureau (if it involves a solicitation for money), or local law enforcement. If you're involved in a Facebook or dating site scam, you are free to contact us direct; (571) 305-4056.   If you have a social security number, you can find information about Soldiers online at Caution-https://www.dmdc.osd.mil/appj/sc... < Caution-https://www.dmdc.osd.mil/appj/sc... > . While this is a free search, it does not help you locate a retiree, but it can tell you if the Soldier is active duty or not.  If more information is needed such as current duty station or location, you can contact the Commander Soldier's Records Data Center (SRDC) by phone or mail and they will help you locate individuals on active duty only, not retirees. There is a fee of $3.50 for businesses to use this service. The check or money order must be made out to the U.S. Treasury. It is not refundable. The address is:  Commander Soldier's Records Data Center (SRDC) 8899 East 56th Street Indianapolis, IN 46249-5301 Phone: 1-866-771-6357  In addition, it is not possible to remove social networking site profiles without legitimate proof of identity theft or a scam. If you suspect fraud on this site, take a screenshot of any advances for money or impersonations and report the account on the social networking platform immediately.  Please submit all information you have on this incident to Caution-www.ic3.gov < Caution-http://www.ic3.gov > (FBI website, Internet Criminal Complaint Center), immediately stop contact with the scammer (you are potentially providing them more information which can be used to scam you), and learn how to protect yourself against these scams at Caution-http://www.ftc.gov < Caution-http://www.ftc.gov > (Federal Trade Commission's website)
  • How can I fill out Google's intern host matching form to optimize my chances of receiving a match?

    I was selected for a summer internship 2016.I tried to be very open while filling the preference form: I choose many products as my favorite products and I said I'm open about the team I want to join.I even was very open in the  location and start date to get host matching interviews (I negotiated the start date in the interview until both me and my host were happy.) You could ask your recruiter to review your form (there are very cool and could help you a lot since they have a bigger experience).Do a search on the potential team.Before the interviews,  try to find smart question that you are going to ask for the potential host (do a search on the team  to find nice and deep questions to impress your host). Prepare well your resume.You are very likely not going to get algorithm/data structure questions like in the first round. It's going to be just some friendly chat if you are lucky. If your potential team is working on something like machine learning, expect that  they are going to ask you questions about machine learning, courses related to machine learning you have and relevant experience (projects, internship). Of course you have to study that before the interview. Take as long time as you need if you feel rusty. It takes some time to get ready for the host matching (it's less than the technical interview)  but it's worth it of course.
  • Are the Los Angeles Lakers out of form this season?

    No, they are just carrying over their form from the last season.Edit:2015: 2014-2015 NBA Regular Season Conference Standings (second to last)2014: 2013-2014 NBA Regular Season Conference Standings (second to last)
  • How do I fill out the form of DU CIC? I couldn't find the link to fill out the form.

    Just register on the admission portal and during registration you will get an option for the entrance based course. Just register there. There is no separate form for DU CIC.
  • How do I treat unrealized losses in equity for ITR? Which form should I fill out?

    There is no procedure for set of unrealized losses in equity from other profit. The actual losses can be set of against the profit of other equities. For the purpose of profit or losses in the transaction of equity, the form no.3 should be filed.
  • How do I form a team to make an app in Los Angeles?

    It is quite expensive to have a high-quality team in Los Angeles. The only way to get some is some salary + shares of your future company.Sure, you can hire some. I would suggest using next resources for this:- Angel list;- Tech Crunch;- Linkedin;- cofounders.The other way is to find freelance developers:- upWork;- Frelancer;- PeoplePerHour etc.In this case, there is a risk to miss the deadline with development and launch. As this team didn’t work together before. Also, there is a risk that any “team member” will disappear.And the last variant:- Find a reliable company or team that has enough experience in app development;- Request portfolio and code samples;- Request for references; (if any is from your country / city - you can even meet with this person);- Compare rates;- Always request for video calls. So you would be able to compare your insights. “listen to your heart”.Hope my tips will help you with your choice.By the way, I’m working with such team and would be pleased to help you with your app development and launch: [email protected],Ivan
  • How do you know if you need to fill out a 1099 form?

    Assuming that you are talking about 1099-MISC.  Note that there are other 1099s.check this post - Form 1099 MISC Rules & RegulationsQuick answer - A Form 1099 MISC must be filed for each person to whom payment is made of:$600 or more for services performed for a trade or business by people not treated as employees;Rent or prizes and awards that are not for service ($600 or more) and royalties ($10 or more);any fishing boat proceeds,gross proceeds of $600, or more paid to an attorney during the year, orWithheld any federal income tax under the backup withholding rules regardless of the amount of the payment, etc.

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How to generate an electronic signature for signing the DSS Los Angeles Form in Gmail

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How to create an electronic signature for the DSS Los Angeles Form on iOS devices

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  • How do I change my IHSS provider?

    To add or change a provider, please call your provider clerk. All new IHSS providers (i.e., providers who are not currently working for any consumers) must be enrolled with the county before they are eligible for payment through the IHSS Program.
  • Can you use DEBT at gas stations?

    You cannot use your benefits to pay for any type of alcohol, so you cannot use your SNAP benefits to buy beer, wine, or malt beverages at grocery stores, gas stations, or anywhere else that accepts the DEBT card. ... This is true even if you are shopping at a store or gas station that accepts the DEBT card.
  • Can you pump gas with DEBT cash?

    You can use your DEBT card and SNAP benefits at a variety of gas stations across the U.S. to purchase food items. If you have TANK cash assistance, you may also be able to purchase fuel.
  • Can you use DEBT cash at gas pump?

    Answer: They can't be used to buy gas, but they can be used to buy food. \u201cEBT cards are accepted at many gas stations that have items such as milk, bread, juice, etc., \u201d Melinda Hartley, director of the Income Support Division of the Forsyth County Department of Social Services, said in an email.
  • How do I become an IHSS provider?

    Attend an on-site, in-person provider orientation to obtain information about IHSS rules and requirements for being a provider. ... Complete and sign the SOC 426 - IHSS Provider Enrollment Form.

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Applicants must meet the Minimum Requirements and achieve a passing score of 70% or higher on the examination in order to be added onto the register of eligible candidates.

Standardized and copyrighted examination materials are not subject to review in accordance with Civil Service Rule 7.19.


Applicants who have taken identical test part(s) for this or any other exam within the last twelve (12) months will have their test responses for the identical test part(s) automatically transferred to this examination. This examination contains test parts that may be used in the future for new examinations. Upon acceptance of your application, your test responses may be transferred to the new examination and you may not be allowed to retake any identical test part(s) for at least twelve (12) months. Depending on the new examination content, your transferred test responses may not result in the same score.


Study guides and other test preparation resources are available to help candidates prepare for employment tests. While the guides will help in preparing for the test, we advise you to review all related materials that you deem necessary.
  • An interactive, Online Test Preparation System for taking practice tests may be accessed on the Department of Human Resources website at http://hr.lacounty.gov/.  Please click on "Find a Job" and then "Job Search Toolkit." Test preparation information is located under the "Employment Test Assistance" section.
  • Additional practice tests are available at https://www.shldirect.com/practice_tests.html.

Applications will be processed on an as-received basis and promulgated to the register of eligible candidates accordingly. The names of candidates receiving a passing grade in the examination will be placed on the register of eligible candidates in order of their score group for a period of twelve (12) months following the date of promulgation. No person may compete in this exam more than once in a 12-month period.

The County of Los Angeles is a Fair Chance employer.  Except for a very limited number of positions, you will not be asked to provide information about a conviction history unless you receive a contingent offer of employment.  The County will make an individualized assessment of whether your conviction history has a direct or adverse relationship with the specific duties of the job, and consider potential mitigating factors, including, but not limited to, evidence and extent of rehabilitation, recency of the offense(s), and age at the time of the offense(s).  If asked to provide information about a conviction history, any convictions or court records which are exempted by a valid court order do not have to be disclosed.

Selective certification registers may be prepared for the following language specialties: AMESLAN, Arabic, Armenian, Cambodian, Cantonese, Farsi, Korean, Lao, Mandarin, Russian, Spanish, Tagalog, and Vietnamese. The Department may also prepare selective certification registers by service areas.

Candidates who wish to have their names placed on a language selective certification register must indicate their foreign language on the application and pass a qualifying language proficiency test on their ability to speak, read, and write English and the specialty language.

As a condition of employment, appointees must successfully pass a training program.  The duration of the training program (approximately 10 - 14 weeks of classroom and on-the-job training) is included in the appointee's one-year probation period.

The resulting eligible register will be used to fill vacancies in the Department of Public Social Services offices located throughout Los Angeles County.


Applications must be filed online only. We must receive your application by 5:00 p.m., PT, on the last day of filing. Applications submitted by U.S. mail, fax, or in person will not be accepted. Apply online by clicking on the green "Apply" button at the top right of this posting. You can also track the status of your application using the website https://www.governmentjobs.com/careers/lacounty.

Many important notifications including invitation letters will be sent electronically to the email address provided on the application. It is important that you provide a valid email address. Please add email addreses [email protected],[email protected],[email protected],[email protected],[email protected],[email protected],  and the domain dpss.lacounty.gov to your list of approved email senders to prevent our email notifications from being blocked or filtered as spam/junk/clutter mail.

Los Angeles County will not consider claims of not viewing or receiving notification to be a valid reason for late test administration or re-scheduling of a test component.

Plan to submit your online application well in advance of the deadline as you may be required to verify your email address.  This only needs to be done once per email address, and if you already have a job seeker account on www.governmentjobs.com/careers/lacounty,you can verify at any time by logging in and following the prompts.  This is to enhance the security of your online application and to ensure you do not enter an incorrect email address.

Notice of Non-acceptance and Final Result letters will be sent via E-mail or USPS, depending on your chosen method of contact in the supplemental questionnaire.  Test scores cannot be given over the phone.

Applicants must submit all applicable documents to be considered (diplomas, official transcripts, certificates, etc.) during application submission.  All documents must be clear and legible. Although resumes can be uploaded as attachments to the application, resumes cannot be accepted in lieu of completing the online application.

Documents not submitted with the application may be emailed to [email protected] must be received within ten (10) calendar days of filing. All emails must clearly identify the applicant's name and the subject line must include the exam name, Eligibility Worker IIand exam number, 491798.

Acceptance of your application depends on whether you clearly show that you meet the Minimum Requirement. Fill out the online application completely and correctly in order to receive full credit for any related education, training, and job experience. For each job held, give the name and address of your employer, your job title, beginning and ending dates, and description of work performed. Utilizing verbiage from the Class Specification and Minimum Requirement will not be sufficient to demonstrate that you meet the requirements. Doing so may result in an incomplete application and disqualification. All information supplied is subject to verification. APPLICATIONS MAY BE REJECTED AT ANY STAGE OF THE SELECTION PROCESS. Falsification of any information may result in disqualification or rescission of appointment.


Please include your Social Security Number for record control purposes.
Federal law requires that all employed persons have a Social Security Number.

Though LA County libraries remain closed, select locations are loaning out laptops and mobile wifi hotspots.  Some LA County public libraries have reopened with limited access hours and may require prior reservation to use their computers.  Applicants can find out more information about reopening at https://lacountylibrary.org/reopening.

All applicants must file their application online using their own user ID and password. Using a family member or friend's user ID and password may erase a candidate's original application record and is subject to disqualification from this examination.

Questions regarding this posting may be emailed, with the exam name Eligibility Worker II and exam number 491798in the subject line, to [email protected]

Americans with Disabilities Act (ADA) Coordinator Phone: (562) 551-3384

ADA Coordinator Email: [email protected]

Teletype Phone: (800) 897-0077

California Relay Services Phone: (800) 735-2922

Department Primary Contact Name:  Veronik Geragoosian at (562) 566-7542

Department Secondary Contact Name:  Romeo Teves at (562) 566-7535
Department Contact Email: [email protected]

Sours: http://agency.governmentjobs.com/lacounty/job_bulletin.cfm?jobID=1552546
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Medi-Cal (not Medicare or medical)
Annual Redetermination form

iii. Redetermination of Eligibility

Change in Circumstances 

The county must determine a beneficiary’s ongoing eligibility upon learning of a change potentially affecting eligibility  [Medi-Cal and the law require changes be reported within 10 days]  from the beneficiary or from its own review as follows:

• Determine if the change in circumstances affects eligibility. For example, a change of address may not affect eligibility for Medi-Cal, but a change in household size might. If there is no change in eligibility based on the new information, no other action is needed.  Another example: If income increases $100/month, but the annual household income remains below the eligibility limit, the individual remains eligible for the same program so no further action is needed.

• If the county determines that the change in circumstances may affect eligibility, the county must attempt to gather all eligibility information using the ex parte process – [beneficiary doesn’t have to appear in person] a review of all available data resources such as the beneficiary’s CalWORKs file or the federal data services hub.

• If the ex parte process does not provide the county the information it needs to find the beneficiary still eligible, the county shall ask the beneficiary for the information it needs. To request information from a beneficiary, the county must use a pre-populated form containing the information that the county already has and that requests only the information needed from the beneficiary to renew eligibility.  The beneficiary has 30 days from the date the pre-populated form is mailed to respond. The beneficiary must be allowed to provide the information requested on the pre-populated form by mail, phone, in person, or any other commonly available electronic means authorized by the county or DHCS.

• During this 30-day period, the county must try to contact the beneficiary by phone, in writing or other commonly available electronic means at least once in an effort to obtain the necessary information. If the beneficiary has identified a preferred method of contact, the county must use that method, otherwise, the county must use reasonable efforts to determine the best method of contact.

• If the beneficiary responds, the county must determine if the beneficiary remains eligible based on the information provided by the beneficiary. If they remain eligible, the county completes the redetermination and sends written notice to the beneficiary. The beneficiary’s next renewal date should be reset to 12 months from the date the county determines the beneficiary is eligible.

° In evaluating information regarding changed circumstances, the county must follow the SB 87 process described at Section A.3.a.iv below and in Welfare & Institutions Code 14005.37 subsection (d) and evaluate the beneficiary for eligibility for all Medi-Cal programs (MAGI and non-MAGI) before terminating the beneficiary from Medi-Cal.   If based on the new information the beneficiary is found not eligible for any Medi-Cal program (if they are over income due to an increase in income or change in family composition, for example) the county must determine eligibility for Covered California with financial assistance.   If eligible, the county should assist the individual with enrollment into Covered California and, if requested, with Covered California plan selection.  After completing the beneficiary’s eligibility determination for Covered California, the county is required to send the beneficiary a ten-day Notice of Action terminating their Medi-Cal.   Note that the county is supposed to take any steps necessary to ensure that a Covered California-eligible beneficiary being discontinued from MediCal can transition to Covered California without a break in coverage.  Beneficiaries found eligible for Share of Cost Medi-Cal must also be evaluated for Covered California financial assistance.   Beneficiaries eligible for Covered California have the choice of having just Share of Cost Medi-Cal, Covered California, or both.

° If the beneficiary does not provide the necessary information to the county within the 30-day period, the county may send the beneficiary a ten-day Notice of Action of terminating Medi-Cal.   At this point in the process, the county is required to immediately evaluate the beneficiary for premium tax credits and forward the case to Covered California.   At the end of the ten days, the beneficiary may be discontinued or terminated from Medi-Cal; however, if the beneficiary provides the  requested information prior to the termination date, the county must rescind the termination action and conduct an eligibility evaluation and redetermination.

° If terminated, the beneficiary still has 90 days from termination to “cure” or provide the information requested and if they do so, the county must treat the information as if it was received timely.  Note that the “good cause” rule regarding submitting information even beyond the 90 days applies.   See also Section B.1 later in this chapter for the Medi-Cal notice and hearing rights, including the right to continue receiving MediCal pending appeal (aid paid pending).

Note that these rules generally apply to both MAGI and Non-MAGI Medi-Cal beneficiaries.

Also note that the county can terminate without doing a redetermination only when it has proof that the beneficiary cannot be eligible for Medi-Cal such as proof that the beneficiary died or moved out of state.   Copied from Western Poverty Guide  *



Sours: https://individuals.healthreformquotes.com/medi-cal/redetermination-3/

Paper documents

Paper verification means documents like pay stubs, utility bills, a driver’s license or an I.D. card for another benefit program. [7 C.F.R. § 273.2(f)(4)(i); MPP § 63-300.5(h)(1).] Documents are the counties primary source of verification for everything except residency and household size. Counties cannot limit verification to any specific type of documentation. [MPP § 63-300.5(h)(1).]

Generally, applicants should bring receipts of recent income and expenses. The CDSS provides a list of documents to bring to the interview. If an applicant cannot get all the information together before the interview, they will have additional time to provide the missing information after the interview. If an applicant needs help getting documentation, he should discuss his needs with the CalFresh case worker during the interview.

References (“collateral contacts”)

References (“collateral contacts”) are non-household members the CalFresh office calls directly to confirm information provided by the household. The CalFresh office should only call collateral contacts when documentation is missing or insufficient. [7 C.F.R. § 273.2(f)(4)(ii); MPP § 63-300.5(h)(2).]

Applicants should designate appropriate collateral contacts for the county case worker. If an applicant does not designate a acceptable collateral contact, the case worker may select a collateral contact. If the household does not want the CalFresh office to contact the person selected by a case worker, the household should be given an alternative means to verify information, or withdraw its application. [7 C.F.R. §§ 273.2(c)(6), (f)(5)(ii).]

Collateral contacts may be made either in person or over the telephone. The acceptability of a collateral contact “shall not be restricted to a particular individual but may be anyone that can be expected to provide an accurate third-party verification of the household’s statements.” [MPP § 300.5 (h)(2).]

Acceptable collateral contacts include employers, landlords, social service agencies, migrant service agencies, and neighbors of the household. The CalFresh office can contact these types of individuals to confirm admissions by the household. For example, the CalFresh office might ask an employer to send a letter confirming wages. Or, the CalFresh office might call a landlord or neighbors to confirm an address.

Broadly speaking, disclosures for verification are permitted and do not violate privacy protections. [7 C.F.R. § 273.2(b)(4), (f)(4)(ii); MPP § 63-300.5(h)(2).] That said, when contacting references, case workers should avoid disclosing that a household has applied for CalFresh benefits. Case workers should not disclose information supplied by the household. [7 C.F.R. §§ 273.1(c), 273.2(f)(4)(i).] Case workers should also not suggest that the household is suspected of any wrong doing.

The county is responsible for obtaining verification from acceptable collateral contacts. [7 C.F.R. 273.2(f)(5)(ii).] The county cannot deem a household ineligible because a person outside of the household fails to cooperate with a request for verification. [7 C.F.R. 273.2(d)1.]

Home visits

The CalFresh office can only use home visits when documentary evidence is insufficient to provide “a firm determination of eligibility or benefit level”. [7 C.F.R. § 273.2(f)(4)(iii).] Home visits should be determined on a case-by-case basis, and must be scheduled in advance with the household [MPP § 63-300.5(h)(3)]. A worker does not have to tell applicants the exact time of the visit. Applicants do not have to let workers visit their home, but this could lead to a denial of benefits.

Home visits conducted by the CalFresh office do not violate the Fourth Amendment or the Due Process clause of the Fourteenth Amendment. [See, e.g., S.L. v. Whitburn, 67 F.3d 1299, 1306-7, 131 (7th Cir. 1995).] When field representatives from the CalFresh office make contact with applicants, they must identify themselves as field representatives, and ask for permission to enter the applicants home.

CalFresh field representatives are not permitted to enter a CalFresh household without consent. Applicants can revoke consent at any time, and the case worker should be careful inform the applicant of this. Once inside the home, field representatives can make note of anything in plain view that has to do with eligibility for CalFresh benefits. The field representative can only search other areas of the home or look in closets, drawers, or other places hidden from view with consent. [See S.L. v. Whitburn, 67 F.3d at 1302.]

Computer and electronic data sources

The CalFresh office can also verify applicant information from computer systems. [7 C.F.R. §§ 273.2(f)(9), 272.8; MPP §§ 63-300.5(h)(4), 20-006.]

California’s Income and Eligibility Verification System (IEVS) is the umbrella term used for the many computer matching systems that assist in the eligibility determination for California public benefit programs. California Food Policy Advocates has created a detailed chart summarizing what IEVS matches with what in California.  IEVS information received directly from the income/benefit source such as SSA is considered verified upon receipt.  [MPP § 20-006.531.]  

The CalFresh office commonly checks information from government and state agencies as well. Some notable federal agencies include the Social Security Administration (SSA) and the Internal Revenue Service (IRS). Some notable state agencies include the California Employment Development Department (EDD), the California Franchise Tax Board (FTB) and the California Department of Motor Vehicles (DMV). These agencies may have the records needed to verify eligibility for CalFresh. The CalFresh office usually will not tell applicants when it is checking information in this way.

The CalFresh office should not immediately act on information it gets from computer records which would result in disqualification or reduction of CalFresh benefits until information is verified. [7 C.F.R. § 272.8(c)(1)(ii), MPP § 20-006.541.]  For IVES information, the county must notify the recipient of the information in writing within 45 days of receiving the data match from CDSS and give 10 days for the recipient to respond.  [MPP § 20-006.543, ACL 17-41.]  A household’s failure or refusal to respond to this notice justifies terminating benefits.  [MPP § 20-006.543(b)(1), ACL 17-41.]  Counties must either establish an overpayment or overissuance or determine that no discrepancy exists by the end of the quarter following the quarter when the county received the IEVS match.  [ACL 17-41.]

There are special rules for information that is unclear, which is information about a household’s circumstances from which the county cannot readily determine the impact on the household’s continued eligibility or benefit amount.  [7 C.F.R. § 273.12(c)(3); ACL 18-20.]  If the information received during the certification period is considered unclear and is less than 60 days old relative to the first day of the month in which the information was received, and indicates the household missed a required report, the county must issue a request for verification to the household.  [ACL 18-20.]  The county must use the CW 2200 form for this request.  [Id.]  The form must inform households that they have 10 days from the date of the form to respond.

If the household responds within 10 days by providing sufficient information, the county must act accordingly to determine continuing eligibility.  If the household does not respond or responds but refuses to provide sufficient information by the specified date, a discontinuance notice is sent to the household.  [Id.]  Note that there must be refusal to provide the requested information to justify termination of benefits.  Failure to provide information is not a basis for adverse action.  Federal regulation defines refusal as “the household must be able to cooperate, but clearly demonstrate that it will not take actions that it can take and that are required.  [7 C.F.R. § 273.2(d), see also MPP § 63-505.12.]

If the information is unclear, is more than 60 days old relative to the first day of the month in which the information was received, and does not indicate the household missed a required report, the county is not required to immediately follow-up on the information and instead will hold the information until the next SAR or recertification.  [ACL 18-20.]

If the county receives unclear information from the Nationwide Prisoner Match or Deceased Persons Match the county must request additional information from the household regardless of the age of the information.  [Id.]  The county must use the CW 2200 form to request additional information.  If the household does not respond or responds but refuses to provide sufficient information, the county shall act on the change by removing the individual from the household and adjusting benefits accordingly.

Counties also use Applicant IEVS at initial application and each subsequent redetermination.  [ACL 19-78.]  Counties must use Applicant IEVS to assist in resolving any potential discrepancies with what was reported on the application (SAWS 2) and/or in the interview.  [Id.]  These discrepancies must be resolved prior to the beginning of a new certification period.  However, the eligibility determination cannot be delayed pending receipt of Applicant IEVS if other information establishes eligibility.  [Id.]

Counties must request Applicant IEVS information at least 15 days prior to the redetermination interview.  If a county cannot resolve a discrepancy relevant to the eligibility determination, the county must provide the client with a CW 2200 verification letter.  [Id.]

Consumer Credit Reports

Counties can also use consumer credit reports to verify information.  For example, CDSS has a contract with “The Work Number” to provide employment verification data.  [ACL 16-43.]  Counties cannot obtain consumer credit reports without written authorization of the applicant or recipient.  Consumer credit reports can be used in conjunction with existing fraud detection resources.  Consumer credit reports cannot be used as the only means of verification.  The SAWS 2 Plus, CF 285 and CF 37 now include authorization for counties to obtain consumer credit reports.

If a county takes adverse action based on information in a consumer credit report, the county must provide an informing notice in addition to the notice of action.  The informing notice must include the name, address and telephone number of the consumer credit reporting agency, a statement that the consumer credit reporting agency did not make the decision, a statement of the right to free disclosure from the consumer credit reporting agency within 60 days and a statement of the right to dispute the accuracy of the information with the consumer credit reporting agency.  [Welf. & Inst. Code § 11023; ACL 16-118]

Information from a consumer credit report must be made available to an applicant or recipient who requests it from the county welfare department or if an applicant requests a fair hearing to regarding the information in the consumer credit report.  [Id.]  Information received from “The Work Number” is not considered verified upon receipt for CalFresh.  [ACL 16-118.]  Counties cannot require applicants or recipients to submit hard-copy documentation that is duplicative of the information obtained from a consumer credit report.  [Id.]

Sours: http://calfresh.guide/how-calfresh-verifies-information/

Verification form income dpss



CalFresh Temporary Student Exemption due to COVID-19:

In response to The Consolidated Appropriations Act 2021, The CalFresh student eligibility rule is now temporarily expanded to include students enrolled at least half-time in an institution of higher education, who either:

• Are eligible to participate in state or federally financed work study during the regular school year, as determined by the institution of higher education, or

 • Have an EFC of zero dollars in the current academic year determined in accordance with part F of title IV of the Higher Education Act of 1965

Qualifying students will receive a letter of verification for this temporary waiver from California Student Aid Commission (CSAC) or their college Financial Aid office.

An application for CalFresh must be submitted along with the required verification to the county office by: GetCalFresh.org , www.mybenefitscalwin.org or paper application.

For those students who are already part of a CalFresh household, the verification must be submitted along with a request to be added to the case. 



P EBT Card

Pandemic EBT update

P-EBT Extension Benefit Amounts

CDSS will issue additional P-EBT benefits for the months of August and September to children who previously received P-EBT, excluding children who have since completed/graduated school. California began mailing NEW P-EBT cards on Monday, October 26, 2020. To reach all eligible children, the state will continue mailing new P-EBT cards through the end of December 2020. Under the approved amendment families will not need to do anything to receive their new P-EBT card and they will not be serving newly eligible children

As a reminder, there is no standard benefit amount under the P-EBT extension. The P-EBT extension benefit amount is based on each student’s learning situation and can vary from student to student, even within a family. 

Note: The County cannot expedite the process

P-EBT 2.0 Updates

States were recently granted authority, pending federal approval, to issue P-EBT benefits to children newly eligible for free or reduced-price school meals for the current 2020-21 school year, including those attending qualifying childcare facilities that have been affected by COVID-19. This is referred to as “P-EBT 2.0”.

Young children are eligible for P-EBT 2.0 if between October 1, 2020, and August 31, 2021, they were:

  • Age 0-6 years old; and
  • Part of a household getting CalFresh food benefits; and
  • Living in a county where at least one school facility is closed or is limiting in-person instruction.

School aged children are eligible for P-EBT 2.0 if they were:

  • Enrolled at a school for school year 2020-21 that participated in the federal School Breakfast Program or National School Lunch Program; and
  • Eligible to get free or reduced-price meals for school year 2020-21; and
  • Assumed to have attended school via all distance learning or a hybrid of all distance learning and in-person learning at least some days of the week during school year 2020-21.

P-EBT 2.0 cards for eligible young children who got CalFresh between October 2020 and January 2021 were automatically mailed beginning early July 2021 through August 2021. P-EBT 2.0 cards for eligible school age children will be automatically mailed beginning early August 2021 through November 2021. P-EBT 2.0 cards for eligible young children who got CalFresh between February 2021 and May 2021 will be automatically mailed beginning in November 2021. All remaining cards for both age groups will be mailed in December 2021.

Cards will be mailed by age group in alphabetical order based on the first name of the eligible child. There is NO P-EBT 2.0 application.

P-EBT Helpline

Families that have already received a P-EBT card and need assistance with PIN set-up, need to request a replacement card, or did not receive their card in the mail as expected, may contact the P-EBT Helpline at (877) 328-9677 (M-F, 6am to 8pm) for help.

Families that have not received a P-EBT card but have questions about their P-EBT eligibility can also contact the P-EBT Helpline at (877) 328-9677 (M-F, 6am to 8pm).

More information: https://www.cdss.ca.gov/home/pandemic-ebt


CalFresh is proud to play a critical role in reducing hunger and poverty and improving health by providing nutrition assistance to millions of low-income households through an array of vital services. CalFresh has the power to reduce hunger, support health, expand opportunity – and even respond to disasters. CalFresh provides monthly benefits to help households purchase the food they need if eligible. CalFresh benefits cannot be used to buy alcoholic beverages, and tobacco products.

We have refreshed our CalFresh logo and have launched a family of CalFresh brands to unite each of our services across food benefits, nutrition education, employment and training, and disaster response under one shared identity. 

CalFresh has three new logos, for the food component, Employment and training and Disaster Response

California to have better access to better food for better living.

CDSS has launched a healthy living website: http://calfresh.dss.ca.gov/healthyliving/Home in partnership with state, county, community partners and local offices to promote healthy eating, physical activity, and food security.

Methods to Apply

  • Apply online 24-hours a day, 7 days a week by going to our Benefits CalWINwebsite, www.MyBenefitsCalWIN.org . Minimum requirements to apply are: Name, Address and Signature
  • Applications can be mailed to: P O Box 1912, Fresno CA 93718
  • By faxing in your application to (559) 600-7706
  • Apply by visiting one of our locations

Need to Speak with a Worker?

Call toll free 1-855-832-8082 Monday through Friday between 7:30 am-4:30 pm

Who Is Eligible

A CalFresh Household may be a family, an individual, or any combination that purchases food and prepares meals together. A child living with parents cannot be a separate household until age 22.

Citizens of the United States or non-citizens who are legally residing in the U.S. are eligible to apply for CalFresh. Non-citizen parents may be able to receive benefits for their children who are citizens. Some income and property limits are reviewed to see if the CalFresh household is eligible. Property used as a home is exempt from property limits.

The benefits you may be eligible to receive depend on your monthly income and household size.

Electronic Benefit Transfer (EBT) Card

If you qualify for CalFresh assistance, you will receive a plastic card called an Electronic Benefit Transfer (EBT) card. You can use your EBT card like a bank debit card to access your CalFresh benefits to purchase food items at most grocery and convenience stores, as well and farmers markets. 

  •  Request a replacement EBT Card by calling 1-877-328-9677
  • Please be cautious as there are many EBT card scams that are occurring.
  • Do not give out your EBT card number and PINs as the county, state, and federal government will NEVER ask you for your EBT card number and PIN by a text message, phone call, email, or on a website.https://www.ebtproject.ca.gov/clients/scam.html
  • You may visit California EBT Project Office to view current scams that have been reported.
  • Check your account balance; find retailers and ATMS that accept your EBT card without charges at the California EBT Client website

EBT Online is here

You can now order groceries online and have them delivered to your doorstep

 You will be able order food online that you would normally buy
with your EBT card in-person and select home delivery*.
*CalFresh Food benefits cannot be used to cover the cost of delivery at this time.

For more information
visit EBT Online at https://www.cdss.ca.gov/ebtonline.
CalWORKs recipients will also be able to use their benefits to make food or other purchases at Walmart. 

Watch our YouTube video for more information 



The County of Fresno Department of Social Services’ response to COVID-19 Coronavirus 

The County of Fresno Department of Social Services (DSS) is committed to assisting adults, children, and families to achieve health, safety and self-sufficiency through a diverse range of programs and partnerships.

DSS has planned, prepared and is responding by adhering to Federal/State/Local public health guidance to help protect you and prevent exposures to COVID-19 Coronavirus. We will continue business operations to meet our goals of providing excellent service delivery to the community. For your safety, we are strongly encouraging you to utilize the resources we have available as many of the services and benefits can be obtained without coming into the office. At this time, all Eligibility interviews will be conducted by telephone.

Fresno County Department of Social Services is promoting online, phone, mail, FAX and internet services. Below are the options you may utilize to access services.

Need to reschedule your appointment or missed your appointment? Call: 1-855-832-8082

 Hours of operations: Monday through Friday from 7:30 a.m. - 4:30 p.m.

24/7 Automated System: 1-877-600-1377

 Case and Benefit Information 


This can be set up by using a computer or downloading the MyBenefitsCalWIN mobile app (Available for iOS and Android) 


With mybenefitscalwin.org, you do not have to visit the office. You can manage your benefits online. Get answers to your basic questions anytime, anywhere

Services Provided:

  • Apply or check eligibility
  • View your current and historical program status
  • Monitor benefit amounts and check EBT balances
  • Manage your periodic reports and renewal forms online
  • Submit periodic reports
  • Communicate with a worker

How to Create a BCW Account

Step 1:  Select create an account

Step 2: Select County of residence

Step 3: Enter your personal information

Step 4: Enter user name/password, select security questions, and sign-in picture

Step 5: Enter your detail information (email address and language) Step 6: You will be asked if you want to view your case information *if Yes, enter your social security number and birthdate

Step 7: Complete the confirmation process

* An email confirmation will be sent to the email address provided
                   * Check your email
                   * Confirm account set-up
                   * Return to My Benefits CalWIN 




Clients can simply visit the site, create an account, and conveniently access self-service options such as:

  • View Case Information
  • View, download, and print Income Grant Verification
  • Check upcoming appointments
  • Upload documents/verifications
  • View community resources

What you will need to create an account:

  • Case number
  • Date of Birth of the Primary Applicant
  • Social Security Number or ID Number from your Benefits Identification Card
  • Valid Email Address

Note: Fresno County DSS employees and their relatives will not be able to create an account

DSS PASS Resources/Links:

 Client and Staff You Tube Informational Videos

Client Video 1: Website Overview

Client Video 2: How to Create A DSS PASS Account

Client Video 3: How to Navigate the DSS PASS Website

Client Video 4: How to Reset Your DSS PASS Password

Client Video 5: Reset Your DSS PASS Password When You Can't Access Your Email

Staff Video 1: ICMS Overview



Pick up your phone and dial 2-1-1 to be automatically connected. 

2-1-1 Fresno County is an Information and Referral Helpline that gets people connected with agencies and/or organizations that can help them in their time of need.  

2-1-1 Fresno County is a free and confidential service that is available 24 hours a day, 7 days a week, and 365 days a year in over 170 languages.

2-1-1 Fresno County is also a Disaster and Emergency Response Center.  If you are outside Fresno County and need assistance, please go to www.211.org to locate a 2-1-1 for your area.


Food Bank

Central California Food Bank and its partners provide services in the community and are dedicated to ending hunger in Central California. You can get information regarding:  Services, locations of fresh produce and the locations of all food distributions by visiting their website. 



market match flyer

Sours: https://www.co.fresno.ca.us/departments/social-services/assistance-programs/calfresh-food-stamps
How to properly fill out a Verification of Employment
Who is it for?

CAPI is a 100 percent state-funded program designed to provide monthly cash benefits to aged, blind, and disabled non-citizens who are ineligible for SSI/SSP solely due to their immigrant status. The welfare reform act of 1996 (P.L. 104-193) eliminated Supplemental Security Income/State Supplementary Payment (SSI/SSP) eligibility for most non-citizens. As a result, most immigrants who were not receiving SSI/SSP in August 1996 are no longer eligible for SSI/SSP.

In order to qualify you must:

  • Meet all other SSI/SSP eligibility criteria except for immigration status
  • Be aged, blind, or disabled
  • Be a resident of California
  • Have resources below the allowable limits of $2,000 for an individual or $3,000 for a couple, and
    • Have income less than the CAPI standards
    • Be a non-citizen and meet the immigration status criteria in effect for SSI/SSP as of 8/21/96
    • Be ineligible for SSI/SSP solely due to immigration status. This means a CAPI applicant must apply or SSI/SSP, or submit other proof of ineligibility from the Social Security Administration

CAPI payment amounts vary depending on a person's marital status, living arrangements and other income. CAPI payment standards are $10 less than SSI/SSP payment standards ($20 for a couple).

How to Apply:

To apply or to find out more about CAPI benefits in Riverside County, please call IHSS HOME at 888-960-4477.

Sours: https://riversideihss.org/Home/IHSSForms

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