Welfare Advocate Forms

Hearings

Select Toggle Title
pdf State Hearing Conditional Withdrawal Form – Fillable ( pdf )
pdf SHD Reopen postpone form ( pdf )
pdf SAR 7 fillable Form ( pdf )
pdf How to get a State Hearing Tape fillable(11 2020) ( pdf )
Default ET Handbook Third Edition 2011 ( pdf )
pdf CF37 RECERTIFICATION FOR CALFRESH BENEFITS Fillable Form ( pdf )
pdf CF303 REPLACEMENT AFFIDAVIT/AUTHORIZATION ( pdf )
pdf CCWRO 2023 FH Request Form ( pdf )
pdf California Department of Social Services Expedited Hearing Request Form ( pdf )
pdf Authorized Representative form DPA19 ( pdf )
pdf 2023 CCWRO FH Subpoena & subpoena decus tecum ( pdf )

IHSS

Select Toggle Title
pdf IHSS- CCWRO IHSS initial Application form ( pdf )
pdf IHSS Provider Travel Time Claim (11 2020) ( pdf )
pdf IHSS Provider Change Request form – 11-2020 ( pdf )
pdf IHSS Paramedical Form SOC 321 with CCWRO addendum ( pdf )
pdf IHSS Advance Payment Request form ( pdf )
pdf IHSS – CCWRO IHSS Protective Supervision Hazard Log Form ( pdf )
pdf IHSS – CCWRO "Request for IHSS Reassessment" form -6-18 ( pdf )
pdf IHSS – 2018 IHSS ranking form for IHSS applicants and recipients ( pdf )
pdf IHSS – 2018 IHSS ranking form for child IHSS applicants or recipients ( pdf )
pdf CCWRO IHSS Reassessment Request Form (12-1-13) ( pdf )
pdf APD Phone Roster 2023-06 ( pdf )

Medi-Cal 250% Program

Select Toggle Title
pdf Medi-Cal 250% employment verification form (3-2020) ( pdf )
pdf Medi Cal 250% Income Verficition form -11-2020 ( pdf )

Welfare To Work

Select Toggle Title
pdf ]WtW fornm – CCWRO CalWORKs WtW Support Services Advance Payment Request(7-17)
pdf WtW Sanction Cure Request Form During the Coronavirus Pandemic- 10-2020
pdf WtW Advance Payment Request form for Books and Transportaton payment
pdf CalWORKs WtW – CCWRO WtW Volunteer to Participate form

CalFresh and CalWORKs

Select Toggle Title
pdf SB 1232 College Book Payment Request for Costs That Exceed the Standard Payment
pdf CalWORKs Stage 1 Child Care Request Form – 2020
pdf CalWORKs Form – 2018 CalWORKs Clock Stoppers Check List
pdf CalWORKs Child Care Request form
pdf CalWORKs – CW 2202W- DSS CalWORKs Policy Interpretation Form
pdf CalWORKs – CCWRO Domestic Violence Waiver Request Form
pdf CalWORKs – CCWRO CalWORKs disability medical verification form
pdf CalWORKs – CalWORKs School Verification Form for Children over 18 and less than 19
pdf CalWORKs – 24-month and 48-month time-clock extender form CW 2186A
pdf CalWORKs & CalFresh – CalWORKs & CalFresh Estimating the value of car(s) Form
pdf CalFresh Form- CCWRO SNAP/CalFresh Purchase & Prepare Statement
pdf CalFresh Form – How to Request to Recomputation of CalFresh Overissuance (OI) When CalWORKs Was Used to Compute the OI
spreadsheet CalFresh Form – CalFresh Medical Transportation Verification form – 2020
pdf CalFresh – CCWRO CalFresh Student Verification Form
pdf CalFresh & CalWORKs Form – Loan Agreement for CalFresh and CalWORKs – 7-19

SSI

Select Toggle Title
pdf SSI – SSI Room rental statement SSA 795.pdf
pdf SSI – SSI expense form
pdf SSI – SSA 795 Continued benefits filing for formal reconsideration