[PDF] Recertification for Calfresh Benefits





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Recertification for Calfresh Benefits

If you prefer to speak read





Sample Cover letter

> Mention what job your are applying for and where you have seen the job ad. Dear Mr Example. SALUTATION. > Use same name as in the address



Supporting documents for applications for Masters degree programs

27 juin 2022 A letter of application in English no more than two pages in length

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What happens after my recertification is approved?

If you reapply timely and get recertified before your certification period ends, you will continue to

receive benefits on your Electronic Benefit Transfer (EBT) card. Continue to use your EBT card and the

same Personal Identification Number (PIN) to buy food. If your EBT card is lost, stolen or destroyed,

call (877) 328-9677 or th2e County right away . For a list of locations near you that accept EBT please go to: https://www.ebt.ca.govor https://www.snapfresh.org.

Rights and Responsibilities

You have a responsibility to:

Give the County all information needed to determine your eligibility. Give the County proof of the information you gave when it is needed. Report changes as required. The County will give you information about what, when, and how to report. If you don"t meet your household"s reporting requirements your CalFresh benefits may be lowered or stopped.

Look for, get, and keep a job or participate in other work-related activities if the County tells you

that it is required in your case. Fully cooperate with county, state, or federal personnel if your case is selected for review or investigation to ensure that your eligibility and benefit level were correctly figured. Failure to cooperate in these reviews could result in loss of your benefits. Pay back any benefits that you were not eligible to get.

You have the right to:

Turn in an application for CalFresh giving only your name, address, and signature. Have an interpreter provided by the County at no cost if you need one.

Have information given to the County kept confidential, unless directly related to the 2administration

of County programs. Withdraw your application at any time prior to the County determining eligibility. Ask for help to fill out your application for CalFresh and get an explanation of the rules. Ask for help to get proof that is needed. Be treated with courtesy, consideration and respect, and not be discriminated against. Be interviewed in a reasonable amount of time by the county when you apply and to have your eligibility determined within 30 days. Get at least 10 days to give requested proof to the County that is neede2d to make a determination of eligibility. Get written notice at least 10 days before the County lowers or stops your CalFresh benefits. Discuss your case with the county and to review your case when you ask to do so. Ask for a state hearing within 90 days if you do not agree with the County about any actions taken on your CalFresh case.

If you ask for a hearing before an action on your CalFresh case takes place, your CalFresh benefits

will stay the same until the hearing or the end of your certification period, whichever is earlier. Ask about your hearing rights or for a legal aid referral at the toll-free phone numbers -

1-800-952- 5253 or for hearing or speech impaired who use TDD, 1-800-952-8349. You may get

free legal help at your local legal aid or welfare rights office. Bring a friend or someone with you to the hearing if you do not want to go alone. Get assistance from the County to register to2 vote. CF 37 (11/16) REQUIRED FORM - NO SUBSTITUTES PERMITTED PROGRAM RULES PAGE 2 OF 7 CalFresh Program Rules Page 2 - Please take and keep for your records. STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES $ Report changes that you are not required to report, if it may increase your CalFresh benefits. $ Give proof of your household"s expenses that may help you get more CalFresh benefits. Not giving proof to the County is the same as saying that you do not have that expense, and you may not be able to get more CalFresh benefits. $ Let the County know if you would like someone else to use your CalFresh benefits for your household or help with your CalFresh case (Authorized Representative). #;91;+7L$>6/You are committing a crime if you give false or wrong information, or do not give all the information on

purposeto try to get CalFresh benefits that you are not eligible to receive, or to help someone else

get benefits that they are not eligible receive. You must pay back any benefits you get that you were

not eligible to receive. a $Lose CalFresh benefits for 12 months for the first offense and be required to repay all

CalFresh benefits overpaid to me

$Lose CalFresh benefits for 24 months for the second offense and be required to repay all

CalFresh benefits overpaid to me

$Lose CalFresh benefits permanently for the third offense and be required to repay all

CalFresh benefits overpaid to me

$Be fined up to $250,000.00,2 imprisoned up to

20 years or both

CF 37 (11/16) REQUIRED FORM - NO SUBSTITUTES PERMITTED PROGRAM RULES PAGE 3 OF 7 CalFresh Program Rules Page 3 - Please take and keep for your records. #;91;+7L(396+=398<

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$Hide information or make false statements $Use Electronic Benefit Transfer (EBT) cards that belong to someone else or let someone else use my card $Use CalFresh benefits to buy alcohol or tobacco $Trade, buy, sell, steal or give away CalFresh benefits or EBT cards, or attempt to trade, buy, sell, steal or give away CalFresh benefits or EBT cards $Try to get dual benefits, for example, apply in two or more different counties or states at the same time $Submit false documents for children or adult household members who are not eligible or who do not exist $Violate conditions of my probation or parole $Flee after a felony conviction $Purchase (buy) a product with CalFresh benefits that has a return deposit, intentionally (on purpose) throw away the contents and return the container for the deposit amount or attempt to return the container for the deposit amount $Buy a product with CalFresh benefits and intentionally resell it for cash or anything other than eligible food STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES Important Information for Noncitizens: You can apply for and get CalFresh benefits for people who

are eligible, even if your family includes others who are not eligible. Getting food benefits will not

affect you or your family"s immigration status. Immigration information is private and confidential. The

immigration status of noncitizens that are eligible and apply for benefits will be checked with the U.S.

Citizenship and Immigration Services (USCIS). Federal law says the USCIS cannot use the information for anything else except cases of fraud. Opting Out: You do not have to give immigration information, social security numbers, or documents for any noncitizen family member(s) who are not applying for CalFresh benefits. However, the County will need to know their income and resource information to correctly determine your household"s CalFresh benefits. The County will not contact USCIS about the 2people who do not apply for CalFresh benefits. Privacy Act and Disclosure: You are giving personal information in the application. The County uses the information to see if you are eligible for benefits. If you do not give the requested information, the County may deny your application. You have the right to review, change, or correct

any information that you gave to the County. The County will not show your information or give it to

others unless you give them permission or federal and state law allows them to do so. 273.2(b)(4) L As a County agency, we must notify all households applying and being recertified for CalFresh benefits of the following: (i) The collection of this information, including the social security number (SSN) of each household member, is authorized under the Food Stamp Act of 1977, as amended, 27 U.S.C. 2011-2036. The information will be used to determine whether your household is eligible or continues to be eligible to participate in the CalFresh Program. We will verify this information through computer matching programs, including the Income and Earnings Verification System (IEVS). This information will also be used to monitor compliance with program regulations and for program management. CF 37 (11/16) REQUIRED FORM - NO SUBSTITUTES PERMITTED PROGRAM RULES PAGE 4 OF 7 CalFresh Program Rules Page 4 - Please take and keep for your records. STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

Trade CalFresh benefits or attemptto trade

CalFresh benefits for: cash, firearms, non-

eligible goods or controlled substances such as drugs

Give false information about who I am and

where I live so I can get extra CalFresh benefits

Have been convicted of trading, selling or

attempting to trade CalFresh benefits worth more than $500, or trading or attempting to trade CalFresh benefits for firearms, ammunition or explosives ose CalFresh benefits for 10 years for each offense

Lose CalFresh benefits permanently Penalties

I may:

Lose CalFresh benefits for 24 months for the

first offense

Lose CalFresh benefits permanently for the

second offense

Program Violations

For CalFresh: I understand I may have

committed an intentional program violation if I do any of the following: FI 48 )22027, YHWcNYHG IUYS . TU acEabNbcbHa VHYSNbbHG VYULYDS YcRHa VDLH 6 UI 8 FjvIEnFr VEypEjw YHvnF Vjpn 6 O VvnjFn Gjun jxm unnz oyE LyHE EnlyEmF/ abDbH UI FDRNIUYTND . MHDRbM DTG McSDT aHYdNFHa DLHTFg FDRNIUYTND GHVDYbSHTb UI aUFNDR aHYdNFHa )ss, This information may be disclosed to other Federal and State agencies for official examination, jxm Gy vjJ nxoyElnwnxG yooslsjvF oyE Grn zHEzyFn yo jzzEnrnxmsxp znEFyxF ovnnsxp Gy jIysm Grn vjJ/ )sss,

If a CalFresh claim arises against your household, the information on this application, including all

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8a. Will there be any changes to this income in the next six months?(Please Check One) LYes LNo

If yes

, explain here: ____________________________________________________________________2_______________________ One-time or ongoing payment How much/How oftenSource of IncomeName Case Name: _____________________________________ Case Number: _____________________________________

Name of Person

Name of School/Training Enrolled Status

a check one) Is this person Working?

LHalf-time or more L

Less than half-time

LNumber of units:________

LNO

LYES,Average work hours

per week:________

7. Do you or anyone you buy and prepare food with get income from a job (earned)?(Please Check One)

LYes LNo

If yes, complete the section below and attach proof. List each job for each person who works. If you need more space, attach a separate

piece of paper and identify which question you are writing about. Examples include babysitting, salary, self-employment, sick pay, tips, etc.

Job #1 Job #2 Job #3

Name of Person who gets

income:

Employer Name:

Self-employed, chec

k L

How often paid:

LWeekly LBiweekly LOther

LMonthly LTwice Monthly

Monthly Gross Amount of

Income: $

Hours worked per month:

Will this income continue?

LYes LNo Self-employed, check

L L

Weekly LBiweekly LOther

LMonthly LTwice Monthly

LYes LNo Self-employed, check

L L

Weekly LBiweekly LOther

LMonthly LTwice Monthly

LYes LNo

CF 37 (11/16) REQUIRED FORM - NO SUBSTITUTES PERMITTED PAGE 2 OF 4

LHalf-time or more

LLess than half-time

LNumber of units:________

LNO

LYES,Average work hours

per week:________

7a. Will there be any changes to anyone"s job or income in the next six months?(Please Check One) LYes LNo

Examples: Stopping, starting, increase or decrease of income, change in hours, quitting a job, going on strike, change in how often

anyone is paid.quotesdbs_dbs1.pdfusesText_1
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