Forms & Publications

CalWORKs

• SAWS 2A SAR - Rights, Responsibilities and Other Important Information English Document (PDF) | SAWS 2A SAR - Rights, Responsibilities and Other Important Information Spanish Document (PDF)
• SAR 7 - Semi-Annual Eligibility Status Report English Document (PDF) | SAR 7 - Semi-Annual Eligibility Status Report Spanish Document (PDF)
• SAR 7 Addendum - Instructions and Penalties English Document (PDF) | SAR 7 Addendum - Instructions and Penalties Spanish Document (PDF)
• AR3 - Mid-Year Status Report for CalWORKs and CalFresh English Document (PDF) | AR3 - Mid-Year Status Report for CalWORKs and CalFresh Spanish Document (PDF)
• SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh English Document (PDF) | SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh Spanish Document (PDF)
• CW 8A - Statement of Facts to Add a Child Under 16 English Document (PDF) | CW 8A - Statement of Facts to Add a Child Under 16 Spanish Document (PDF)
• National Voter Registration Act (NVRA) Voter Preference Form English Document (PDF) | NVRA Voter Preference Form Spanish Document (PDF)

CalFresh

• SAWS 2A SAR - Rights, Responsibilities and Other Important Information English Document (PDF) | SAWS 2A SAR - Rights, Responsibilities and Other Important Information Spanish Document (PDF)
• SAR 7 - Semi-Annual Eligibility Status Report English Document (PDF) | SAR 7 - Semi-Annual Eligibility Status Report Spanish Document (PDF)
• SAR 7 Addendum - Instructions and Penalties English Document (PDF) | SAR 7 Addendum - Instructions and Penalties Spanish Document (PDF)
• SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh English Document (PDF) | SAR 3 - Mid-Year Status Report for CalWORKs and CalFresh Spanish Document (PDF)
• CW 8A - Statement of Facts to Add a Child Under 16 English Document (PDF) | CW 8A - Statement of Facts to Add a Child Under 16 Spanish Document (PDF)
• NVRA Voter Preference Form English Document (PDF) | NVRA Voter Preference Form Spanish Document (PDF)
• CF 377.5 - CalFresh Household Change Report English Document (PDF) | CF 377.5 - CalFresh Household Change Report Spanish Document (PDF)

Medi-Cal / County Medical Services Program

• Application for Medi-Cal and Covered California health care options All Languages Documents
• NVRA Voter Preference Form English Document (PDF) | NVRA Voter Preference Form Spanish Document (PDF)
• MC 219 - Important Information for Persons Requesting Medi-Cal English Document (PDF) | MC 219 - Important Information for Persons Requesting Medi-Cal Spanish Document (PDF)

Welfare-to-Work

• WTW 1 - WTW Plan Rights and Responsibilities English Document (PDF) | WTW 1 - WTW Plan Rights and Responsibilities Spanish Document (PDF)
• SSSD 3000 - Monthly Participant Timecard English / Spanish Document (PDF)
• SSSD 3007 - Job Search Log and Mileage English / Spanish Document (PDF)
• CW 2186A - Exemption Request Form English Document (PDF) | CW 2186A - Exemption Request Form Spanish Document (PDF)
• WTW 31 - Request to Stop a WTW Sanction English Document (PDF) | WTW 31 - Request to Stop a WTW Sanction Spanish Document (PDF)

General Assistance

• SSSD 3007 - Job Search Log and Mileage English / Spanish Document (PDF)