Printable Los Angeles County Department Of Social Services Affidavit Form Click on one of the following links to view forms whose form number begins with the corresponding A D E H I L M P Q T U Z
To find a form click on the link after the program name to find forms whose form number begins with those letters Problems with downloading forms Click here Tips for Using Adobe PDF Files Adoptions AAP and AD Assistance Dog Special Allowance ADSA CalFresh CF DFA EP QR SAR and SAWS CDSS collects personal information directly from individuals who volunteer to obtain some of our services Collection of this information is required to deliver the specific services but use of these services is voluntary Failure to provide requested information may result in a denial of services
Printable Los Angeles County Department Of Social Services Affidavit Form
Printable Los Angeles County Department Of Social Services Affidavit Form
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General Relief GR is a County funded program that provides cash aid if you are an adult without any income or resources and children in certain special circumstances who are ineligible for federal or State programs Click here for more information What Is General Relief GR Part 1 Watch on Please print and fill out the Application for CAPI Once completed mail it to Metro North District Office 2601 Wilshire Blvd Los Angeles CA 90057 ATTN CAPI APPLICATION Or fax it to 213 368 7959 Access the Application for CAPI
File application Learn More Fees Learn More Recent Updates Effective April 2023 New and updated applications and forms were added DRP Base Application Referrals Letters Animal Care and Control License Referral ACC License Referral Supplemental Form Business License Referral For businesses that need a license to open or continue operations Business License Once in a lifetime temporary shelter payments for up to 16 consecutive calendar days An eligible family may receive 65 per day for a family of up to four and 15 per day for each additional person up to a maximum of 125 per day The family must be actively searching for permanent housing provide verification for the housing search and
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ANY PERSON WHO SIGNS THIS STATEMENT AND WHO WILFULLY STATES AS TRUE ANY MATERIAL MATTER WHICH HE KNOWS TO BE FALSE IS SUBJECT TO THE PENALTIES PRESCRIBED FOR PERJURY IN THE PENAL CODE BY THE STATE OF CALIFORNIA SEC 11054 OF THE W I CODE WITNESSED AND VERIFIED BY TITLE DATE 76A303 PA 853 Rev 11 72 IHSS Fraud Hotline 1 888 717 8302 Help Stop Medi Cal Fraud and Abuse Provider Fraud and Elder Abuse complaint line 1 800 722 0432 Other Links Looking for Cash Assistance Looking for In Home Supportive Services Need Adult Protective Services
STEP 1 Fill out sign and file with 2 extra copies the following forms To file for guardianship of the person only use Petition for Appointment of Guardian of Person Form GC 210 P To file for guardianship of the minor child s estate only OR of the minor child s person and estate use Petition for Appointment of Guardian of Minor Form If you need assistance completing any of these forms please contact the IHSS Helpline at 888 822 9622 You have the right to interpreter services provided by the County at no cost to you SOC 295 Application For IHSS English Armenian Cambodian Chinese Farsi Korean Russian Spanish Tagalog Vietnamese SOC 295L Application For IHSS Large Print
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https://www.cdss.ca.gov/inforesources/forms-brochures/forms-alphabetic-list
Click on one of the following links to view forms whose form number begins with the corresponding A D E H I L M P Q T U Z
https://www.cdss.ca.gov/inforesources/forms-brochures/forms-by-program
To find a form click on the link after the program name to find forms whose form number begins with those letters Problems with downloading forms Click here Tips for Using Adobe PDF Files Adoptions AAP and AD Assistance Dog Special Allowance ADSA CalFresh CF DFA EP QR SAR and SAWS
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Free Printable Affidavit Of Service Form FREE PRINTABLE TEMPLATES
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Printable Los Angeles County Department Of Social Services Affidavit Form 2023
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