calfresh application form : How to Download calfresh application form
Use this application if you are applying for food assistance (CalFresh), cash aid (California Work Opportunity and Responsibility to Kids, Refugee Cash Assistance, General Assistance or General Relief), Medi-Cal and/or other health care programs. If you want to apply for CalFresh only, you can ask the County for the CalFresh only application. CalFresh is a food assistance program to help you with the cost of buying food for your household. If you want to apply for health care only, you can ask the county for a health care only application. Health care includes: low-cost insurance for Medi-Cal; affordable private health insurance; or a tax credit that can help you pay your premiums for health coverage. Do not use this application if you are applying for only health care. Your County may have a separate application for General Assistance or General Relief. Ask your County to be sure.
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How to Download the CalFresh Application Form
The CalFresh program, also known as the Supplemental Nutrition Assistance Program (SNAP) in other states, provides vital food assistance to eligible individuals and families in California. To apply for CalFresh benefits, you'll need to fill out an application form. In this article, we'll guide you through the process of downloading the CalFresh application form so that you can get started on your application.
How do I calfresh apply?
- You can also apply for these programs online by going to http://www.benefitscal.org/.
- Fill out the whole application form, if you can. You must at least give the County your name, address, and
- signature (question 1 on page 1 of the application) to begin the application process for CalFresh. For cash aid
- you must fill out questions 1 through 5 on pages 1 and 2 of the application and sign it to begin the application
- process. For General Assistance or General Relief ask the County which questions must be answered to begin
- the application process.
- Each program has a symbol (shown at the top of this page) showing what questions pertain to what programs.
- For cash aid, it is a dollar sign; for CalFresh, it is a shopping cart; and for health coverage, it is an ambulance.
- For example, if you are not applying for cash aid, you don’t need to answer questions marked only with a dollar
- Give the application to the County in person, by mail, by fax or online.
- The day the County receives your signed application starts the time to give you an answer on whether you can
- get benefits. If you are in an institution, this time starts from the day you leave.
What do I do next?
- Read about your rights and your responsibilities (Program Rules pages) before you sign the application.
- You must have an interview with the County to discuss your application. If you have a disability, other
- arrangements can be made.
- If you did not fill out all of the application, you can finish it during your interview.
- You will need to give proof of your income, expenses, and other circumstances to see if you are eligible.
How long will it take?
It may take up to 30 days to process your application for CalFresh. For cash aid and Medi-Cal, it may take up to 45 days. Ask the County how to get your benefits or health care right away if you have an emergency.
You may be able to get CalFresh benefits within 3 calendar days if:
- Your household’s monthly gross income (income before deductions) is less than $150 and your cash on hand
- or in checking or savings accounts is not more than $100; or
- Your household’s housing costs (rent/mortgage and utilities) are more than your monthly gross income and
- money in checking or savings; or
- You are a migrant or seasonal farmworker household with less than $100 in checking or savings and 1) your
- income stopped, or 2) your income has started but you do not expect to get more than $25 in the next 10 days.
For cash aid, you may get immediate assistance if:
- You are homeless or have an eviction notice or a notice to pay rent or move; or
- Your food will run out within three days; or
- Your utilities have been or will be shut off; or
- You don’t have sufficient clothing or diapers; or
- You have another kind of emergency important to health and safety.
Overview calfresh application form
|Program Department||California Department of Social Services|
|Program Benefits||Monthly food assistance|
|Program Eligibility||Low-income individuals and families|
|Program Documents||Application form, proof of income, ID|
|Program Official Website||Official CalFresh Website|
Informational Page - Please take and keep for your records.
To help the County see if you can get benefits faster, please complete questions 1, 6 through 9, 15, and 24, and give the County proof of your identity (if you have it) with the application. For General Assistance or General Relief, ask the County how long it will take and about any special rules for getting benefits faster. The County will send you a letter to let you know if your household is approved or denied for the benefits you applied for.
How to Get EBT Cash Benefits
What do I need for my interview?
To avoid delays, bring proof of the following items with you to your interview. Keep your interview even if you do not have the proof. The County may be able to help if you need help getting proof. During the interview, the County will go over the information on the application and will ask you questions to see if you can get benefits and the amount of benefits you can get.
Proof Needed to Get Benefits
- Identification (Driver’s License, State ID card,
- Birth certificates for everyone applying for cash
- Proof of where you live (rental agreement, current bill with your address listed).
- Social Security numbers for everyone applying
- for aid (see note below about certain
- Money in the bank for all the people in your
- household (recent bank statements).
- Earned income of everyone in your household
- for the past 30 days (recent pay stubs, a work
- statement from an employer). NOTE: If
- self-employed, income and expenses or tax
- Unearned income (Unemployment benefits, SSI,
- Social Security, Veteran’s benefits, child support,
- worker’s compensation, school grants or loans,
- rental income, etc.).
- Lawful immigration status ONLY for legal
- noncitizens applying for benefits (an Alien
- Registration Card, visa).
- NOTE: Certain noncitizens applying for
- immigration status based on domestic violence,
- crime prosecution or trafficking may not need this
- proof. They also may not need a Social Security
Proof Needed to Get More CalFresh Benefits
- Housing costs (rent receipts, mortgage bills,
- property tax bill, insurance documents).
- Phone and utility costs.
- Medical expenses for anyone in your household
- who is elderly (60 and older) or disabled.
- Child and adult care costs due to someone
- working, looking for work, attending training or
- school, or participating in a required work activity.
- Child support paid by a person in your
Additional Proof Needed for Health Coverage
- Information about any job related health
- insurance available to your family.
- Policy numbers for any current health insurance.
Additional Proof Needed for Cash Aid
- Proof of immunizations for children six years of
- age or younger.
- Vehicle registration for vehicles owned by you or
- someone you are applying for.
What if I am homeless?
Please let the County know right away if you are homeless so they can help you figure out an address to use to accept your application and get notices from the County regarding your case. For CalFresh and cash aid, homeless means you are:
- A. Staying in a supervised shelter, halfway house, or similar place.
- B. Staying at the home of another person or family for no more than 90 days straight.
- C. Sleeping in a place not designed for, or normally used as, a place to sleep (a hallway, a bus station, a
- lobby, or similar places).
You have a responsibility to:
- Give the County all information needed to determine your eligibility.
- • Give the County proof of the information you have when it is needed.
- • Report changes as required. The County will give you information about what, when, and how to report. For CalFresh
- and cash aid if you don’t meet your household’s reporting requirements, your case may be closed or your benefits may
- be lowered or stopped.
- • Look for, get, and keep a job or participate in other 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 will result in loss of your
- • Pay back any cash aid or CalFresh benefits that you were not eligible to get
How to Create a BenefitsCal Account Step-by-Step
You have the right to:
- Turn in an application for CalFresh giving only your name, address, and signature.
- • Have an interpreter provided by the State at no cost if you need one.
- • Have information given to the County kept confidential, unless directly related to the administration of County programs.
- • Withdraw your application at any time prior to the County determining eligibility.
- • Ask for help to fill out your application or help getting the proof that you need and get an explanation of the rules.
- • Be treated with courtesy, consideration, and respect, and not be discriminated against.
- • Get CalFresh benefits within 3 days if you qualify for Expedited Service.
- • Get cash aid within one day if you qualify for Immediate Need.
- • Be interviewed in a reasonable amount of time by the County when you apply and to have your eligibility determined
- within 30 days for CalFresh or 45 days for cash aid and Medi-Cal.
- • Get at least 10 days to give to the County proof that is needed to make a determination of eligibility.
- • Get written notice at least 10 days before the County lowers or stops your CalFresh or cash aid 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 your case. If you ask for a hearing
- before an action on your case takes place, your benefits will stay the same until the hearing or the end of your certification
- period, whichever is earlier. You can ask the County to let your benefits change until after the hearing to avoid having to
- pay back any overpaid benefits. If the Administrative Law Judge rules in your favor, the County will give back to you any
- benefits that were cut.
- 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
- • Bring a friend or someone with you to the hearing if you do not want to go alone.
- • Get help from the County to register to vote.
- • Report changes that you are not required to report, if it may increase your CalFresh benefits or cash aid.
- • 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 will 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).
- You are also giving the Medi-Cal agency the right to pursue and get medical support from a spouse or parent. If you
- think that cooperating to collect medical support will harm you or your children, you can tell the Medi-Cal agency and
- you may not have to cooperate.
Program Rules and Penalties
You are committing a crime if you give false or wrong information, or do not give all the information on purpose to try to get CalFresh, cash aid, and Medi-Cal, that you are not eligible to receive, or to help someone else get benefits that they are not eligible to receive. You must pay back any benefits you get that you were not eligible to receive. If you do this on purpose and receive more than $950 in benefits you were not eligible to receive, you can be charged with a felony
How much is the CalFresh Income Limit
Important Information for Noncitizens
- You can apply for and get CalFresh benefits, cash aid, or health care for people who are eligible, even if your family includes others who are not eligible. For example, immigrant parents may apply for CalFresh benefits, cash aid, or health
- care for their U.S. citizen or qualified immigrant children, even though the parents may not be eligible.
- • Getting food benefits will not affect you or your family’s immigration status. Immigration information is private and
- • The immigration status of noncitizens who 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.
- You do not have to give immigration information, Social Security numbers, or documents for any noncitizen family member(s)
- who are not applying for benefits. The County will need to know their income and resource information to correctly determine
- your household’s benefits. The County will not contact USCIS about the people who don’t apply for benefits.
Use of Social Security Numbers (SSN)
- CalFresh and Cash Aid: Everyone applying for CalFresh benefits or cash aid needs to provide a SSN, if you have one, or
- proof that you have applied for a SSN (such as a letter from the Social Security office). We can deny you or any member of
- your household who does not give us a SSN. Some people do not have to give SSNs to get help such as, victims of domestic
- abuse, crime prosecution witnesses, and trafficking victims.
- Health Coverage/Medi-Cal: We need your SSN if you want health coverage and have a SSN. Providing your SSN can be
- helpful if you don’t want health coverage too since it can speed up the application process. We use SSNs to check income
- and other information to see who’s eligible for help with health coverage costs. If someone wants help getting a SSN,
- Call 1-800-772-1213 or visit the website: www.socialsecurity.gov
- This means you got more CalFresh benefits than you should have. You will have to pay it back even if the county made an
- error or if it wasn’t on purpose. Your benefits may be lowered or stopped. Your SSN may be used to collect the amount of
- benefits owed, through the courts, other collection agencies, or federal government collection action.
Please take and keep for your records
- Overpayment This means that you got more cash aid than you should have gotten. Just like with CalFresh benefits, you will have to pay it back even if the County made an error or if it wasn’t on purpose. Your cash aid may be lowered or stopped. Your SSN may be used to collect the amount of benefits owed, through the courts, other collection agencies, or federal government collection action.
- Reporting Every household that gets benefits must report certain changes. Your county will tell you what changes to report, how to report them, and when to report them. Failure to report the changes may result in your benefits being lowered or stopped. You can also report if things happen that may increase your benefits, such as getting less income.
- State Hearings You have the right to a State hearing if you do not agree with any action taken regarding your application or your ongoing benefits. You can request a State hearing within 90 days of the County’s action and you must tell why you want a hearing. The approval or denial notice you receive from the County will have information on how to request an appeal. If you ask for a hearing before the action happens, you may be able to keep your cash aid and CalFresh benefits the same until a decision is made.
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 information, the County may deny your application. You have a 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. The County will verify this information through computer matching programs, including the Income and Earnings Verification System (IEVS). This information will be used to monitor compliance with program regulations and for program management. The County may share this information with other federal and state agencies for official examination, with law enforcement officials for the purpose of arresting persons fleeing to avoid the law, and with private claims collection agencies for claims collection action. The County may verify immigration status of household members applying for benefits by contacting the USCIS. Information the County gets from these agencies may affect your eligibility and level of benefits.
The County will use the information from your application to check your eligibility for help with paying for health coverage. The County will check your answers using information in state and federal electronic databases and databases from the Internal Revenue Service (IRS), Social Security Administration, the Department of Homeland Security, and/or a consumer reporting agency. If the information doesn’t match, the County may ask you to send proof.
It is the State and County’s policy that all people be treated equally, and with respect and dignity. In accordance with federal law and the U.S. Department of Agriculture (USDA) Policy, discriminating on the basis of race, color, national origin, sex, age, religion, political beliefs, or disabilities is strictly prohibited.
Work Rules for CalWORKs (Welfare-to-Work)
If you get cash aid, you must participate in Welfare-to-Work (WTW) unless you are exempt. The county will tell you if you are exempt from WTW. If you do not do your assigned activities your cash aid may be lowered or stopped.
CalWORKs - Fingerprinting/Photo Imaging
All eligible adult household members for cash aid must be fingerprinted/photo-imaged. If anyone who is required to cooperate with these rules does not get fingerprinted/photo-imaged, no benefits will be issued to the entire household. The fingerprint/photo images are confidential and can only be used to prevent or prosecute welfare fraud.
How do I get/use my benefits? CalFresh and Cash Aid:
- The County will mail or give you a plastic Electronic Benefit Transfer (EBT) card. Benefits will be put on the card when
- your application is approved. Sign your card when you get it. You will set up a Personal Identification Number (PIN) to
- get cash from ATMs or to buy food and/or other items.
- • If your EBT card is lost, stolen, destroyed or you think someone may know your PIN number that you don’t want to use
- your benefits call (877) 328-9677 or call the County right away to report it and change your PIN number. Make sure all
- responsible adults and your authorized representative also know how to report one of these problems right away. Any
- benefits taken from your account before you report the EBT card or PIN lost or stolen will NOT be replaced.
- • You can use your CalFresh benefits to buy almost all foods, as well as seeds and plants to grow your own food. You
- cannot buy alcohol, tobacco, pet food, some types of cooked food, or anything that is not food (like toothpaste, soap, or
- paper towels).
- • CalFresh benefits are accepted at most grocery stores and other places that sell food. Cash aid can be used at most
- stores and most ATMs. Some ATMs may charge a fee. There may also be a fee if you use an ATM to get cash after
- three withdrawals. For a list of locations near you that accept EBT, please go to: https://www.ebt.ca.gov or
- https://www.snapfresh.org. You can also find out where you can get cash without paying a fee.
- • CalFresh benefits are only for you and your household members. Your cash aid is only for you and the members of your
- family who were approved for cash aid. Your cash aid is to help meet the basic needs of your family (housing, food,
- clothing, etc.). Keep your benefits safe. Do not give out your PIN number. Do not keep your PIN number with your EBT
- • Any use of your EBT card by you, a household member, your authorized representative, or anyone you voluntarily give
- your EBT card and PIN to will be considered approved by you and any benefits taken from your account will NOT be
Medi-Cal and Health Care:
- For Medi-Cal, you will receive a Benefits Identification Card (BIC).
- • Sign your BIC when you get it and use it only to get necessary health care services.
- • Never throw your BIC away (unless we give you a new BIC). You need to keep your BIC even if you stop getting
- Medi-Cal. You can use the same BIC if you get cash aid or Medi-Cal again.
- • Take the BIC to your medical provider when you or a family member is sick or has an appointment.
- • Take the BIC to the medical provider who treated you or your family member(s) in an emergency situation as soon
- as possible after the emergency.
- • For other health care programs you will receive a health plan card from your particular carrier.
General Assistance and General Relief:
- General Assistance and General Relief are County run programs for adults without children. The County will tell you
- about your rights and responsibilities and the program rules if you are applying for one of these programs.
HOUSEHOLD’S AUTHORIZED REPRESENTATIVE
You may authorize someone 18 years or older to help your household with your CalFresh benefits. This person can also speak for you at the interview, help you complete forms, shop for you, and report changes for you. You will have to repay any benefits you may get by mistake because of information this person gives the County and any benefits you didn’t want them to spend will not be replaced. If you are an Authorized Representative you will need to give the County proof of identity for yourself and the applicant. Do you want to name someone to help you with your CalFresh case?
Download calfresh application form
To download calfresh application form, you can download calfresh application form pdf by clicking on this link
calfresh application form Step-by-Step Guide
- Visit the Official Website:- To access the CalFresh application form, start by visiting the official website of the California Department of Social Services (CDSS). You can do this by typing "CalFresh application form California" into your preferred search engine or by going directly to the CDSS website.
- 2. Navigate to the CalFresh Section:- Once on the CDSS website, look for the section dedicated to CalFresh or SNAP. This section typically contains resources and information related to the program.
- 3. Locate the Application Form:- Within the CalFresh section, you should find a link or button that allows you to download the CalFresh application form. This link may be labeled "Apply for Benefits" or something similar.
- 4. Click on the Download Link:- Click on the provided link to access the CalFresh application form. The form is usually available in PDF format, which can be opened with a PDF reader such as Adobe Acrobat Reader.
- 5. Download and Save the Form:- After clicking the download link, the application form will open in your web browser or PDF reader. To download it, click on the download icon or select the "Save" option from the file menu.
- 6. Choose a Location for Saving:- You will be prompted to choose a location on your computer or device where you want to save the downloaded application form. Select a location that you can easily remember, such as your desktop or documents folder.
- 7. Open the Downloaded Form:- Once the form is downloaded and saved, navigate to the location where you saved it and double-click to open it. You can now begin filling out the CalFresh application.
- 8. Complete the Application:- Fill out the application form with accurate and complete information. Be sure to follow the instructions provided on the form and include all required details.
- 9. Save a Copy for Your Records:- After completing the application, save a copy of the filled form on your computer for your records. This can be helpful for reference and in case you need to make updates or reapply in the future.
- 10. Submit Your Application:- Follow the submission instructions provided on the application form. You may need to submit the form in person, by mail, or online, depending on your county's requirements.