Right Column
Cambodian Translations
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For Cambodian forms beginning with the following letters click below:
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z |
- AD 1A (08/02) - Consent To Adoption By Parent(s) (In California)
- AD 501 (09/03) - Relinquishment In or Out-of-County (Birth Mother/Presumed Father in California)
- AD 887 (9/03) - Statement Of Understanding Independent Adoptions Program
- CCP 1 (1/08) - Declaration of Exemption from Trustline Registration and Health and Safety Self-Certification
- CCP 4 (1/08) Health and Safety Self-Certification (for license exempt providers)
- CCP 6 (8/99) - Health And Safety Checklist
- CCP7 (01/08) - CalWORKs Stage One Child Care Request Form And Payment Rules
- CALIFORNIA WORK OPPORTUNITY AND RESPONSIBILITY TO KIDS HANDBOOK
- CL 1 (4/99) - Cal-Learn Registration Program Information Orientation Appointment
- CL 2 (4/99) - Cal-Learn Program Requirements
- CL 3 (4/99) - Cal-Learn Notice Of A Participation Problem
- CL 4 (4/99) - Cal-Learn Notice To Parent/Legal Guardian Of Cal-Learn Participant
- CL 8 (3/99) - Cal-Learn Notice Of Report Card Submittal Schedule
- CL 9 (3/99) - Cal-Learn Notice Of Good Cause Determination
- CL 10 (4/99) - Cal-Learn Notice Of Exemption/Deferral
- CL 11 (4/99) - Cal-Learn Notice Of Incomplete Grades
- CW 2.1 (3/00) - Notice And Agreement For Child, Spousal And Medical Support
- CW 2.1Q (7/01) - Support Questionnaire
- CW 5 (07/01) - Veterans Benefits Verification and Referral
- CW 8 (7/01) - Statement of Facts For An Additional Person
- CW 8A (3/00) - Statement of Facts To Add A Child Under Age 16
- CW 10 (7/01) - Notice of Withdrawn Application
- CW 23 (3/00) - Senior Parent - Statement Of Facts
- CW 25 (7/01) - Supplemental Statement Of Facts - Minor Parent
- CW 40 (3/00) - CalWORKs - Reduced Income Supplemental Payment Request
- CW 43 (3/00) - CalWORKs Applicant Choice Form Immediate Need Payment/Expedited Grant
- CW 61 (07/01) - Authorization to Release Medical Information
- CW 61A (06/01) - Physical Capacities
- CW 61B (06/01) - Mental Capacities
- CW 71 (3/00) - Statement Of Cash Aid Mother And Unrelated Adult Male (UAM)
- CW 81 (7/01) - Lien Agreement
- CW 82 (3/00) - Important Information About This Agreement
- CW 86 (3/00) - Agreement - Restricted Account - California Work Opportunity And Responsibility To Kids (Calworks) Program
- CW 88 (5/00) - You May Be Eligible For Diversion Services
- CW 103 (7/99) - Transitional Medi-Cal
- CW 2102 (8/00) - The Maximum Family Grant (MFG) Rule for Recipients of Cash Aid
- DFA 285-A1 (1/07) - Application For Food Stamp Benefits
- DFA 285-A2 (8/06) - Statement Of Facts
- DFA 285-A3 QR (5/06) - Food Stamp Benefits Your Rights And Responsibilities
- DFA 285C (04/99) - Food Stamp Supplemental Application For Special Medical Deductions
- DFA 303 (03/05) - Replacement Affidavit/Authorization
- DFA 377.1 (11/01) - Notice of Approval
- DFA 377.1A (03/02) - Notice Of Denial Or Pending Status
- DFA 377.4A (07/03) - Food Stamp Notice of Change
- DFA 377.4 QR (1/04) - Food Stamp Notice Of Change For Change Reporting Household
- DFA 377.5 (8/06) - Food Stamp Household Change Report
- DFA 377.7A (07/99) - Notice Of Administrative Disqualification
- DFA 377.7B (12/03) - Food Stamp Repayment Notice For Inadvertent Household Errors Only
- DFA 377.7B1 (10/00) - Food Stamp Repayment Notice for Inadvertant Household Errors Only, Final Notice
- DFA 377.7C (05/02) - Food Stamp Repayment Agreement For Inadvertent Household Errors Only
- DFA 377.7D (6/01) - Food Stamp Repayment Notice for Administrative Errors Only
- DFA 377.7D1 (6/01) - Food Stamp Repayment Notice for Administrative Errors Only
- DFA 377.7D2 (10/00) - Food Stamp Repayment Notice for Administrative Errors Only, Final Notice
- DFA 377.7D3 (12/03) - Food Stamp Repayment Notice For Administrative Errors Only
- DFA 377.7E (7/04) - Food Stamp Repayment Agreement For Administrative Errors Only
- DFA 377.7E1 (05/02) - Food Stamp Repayment Agreement For Administrative Errors Only
- DFA 377.7F (08/01) - Food Stamp Repayment Notice For An Intentional Program Violation (IPV) Or Status Change From Inadvertent Household Error (IHE) To An IVP
- DFA 377.7F1 (10/00) - Food Stamp Repayment Notice for an Intentional Program Violation (IPV) Only, Final Notice
- DFA 377.7G (05/02) - Food Stamp Repayment Agreement For An Intentional Program Violation (IPV) Only
- DFA 377.9 (8/01) - Notice of Back Food Stamp Benefits
- DFA 377.10 (6/04) - Food Stamp Notice Of Disqualification
- DFA 377.11 (9/04) - Food Stamp Notice Of Discontinuance - Failure To Meet The ABAWDs Work Rule
- DFA 377.11A (9/04) - Food Stamp Notice of Continuance - 1st Failure to Meet ABAWD Work Requirement
- DFA 377.11B (11/00) - Food Stamp Notice Of Discontinuance - 2nd Or Subsequent Discontinuance For Failure To Meet ABAWD Work Requirement
- DFA 385 (5/99) - Application For Emergency Food Stamp Assistance
- DFA 386 (03/02) - Notice of Missed Interview
- DFA 387 (03/02) - Request For Information
- DFA 478 (8/01) - Disqualification Consent Agreement Food Stamp Program
- DPA 353 (4/00) - Notice Of Aid To Families With Dependent Children (AFDC) And/Or Food Stamp Administrative Disqualification Hearing
- DPA 435 (2/02) - County Allegation Of Intentional Program Violation/Statement Of Position (Request For An Administrative Disqualification hearing)
- EFA 7A (11/99) - Emergency Food Assistance Program (EFAP) Certification Of Eligibility
- FS 9 (3/01) - Food Stampsimportant Information
- FS 11 ENG/CAMBODIAN (8/07) - Notice To All Food Stamp Recipients
- FS 13 ENG/CB (09/99) - Notice To All Food Stamp Household Members Who Must Pay Child Support Important - Please Read
- FS 17 ENG/CB (9/99) - Notice To All Food Stamp Recipients - Important Information For Legal Immigrants
- FS 22 QR (12/06) - Applying For Food Stamp Benefits
- FS 23 QR (3/05) - Food Stamp Benefits How To Report Household Changes
- FS 26 (3/05) -Food Stamp Program Qualifying Drug Felon Addendum
- GEN 1179 (11/07) - Complaint Of Discrimination
- LIC 9151 (3/05) - Family Child Care Home Property Owner/Landlord Notification
- NA 211 (1/00) - Notice of Action
- NA 692 (12/07) - Notice Of Change Cash Assistance Program For Immigrants (Capi)
- NA 693 (4/99) - Notice Of Approval Cash Assistance Program For Immigrants (Capi)
- NA 801 (11/99) Notice of Action
- NA 802 (11/99) Notice of Action
- NA 803 (11/99) Notice of Action (Continued)
- NA 818 (10/06) - Notice Of Action - Taking You Out Of Welfare To Work
- NA 822 (01/01) - Notice Of Action - Transportation Change
- NA 832 (01/08) - Notice of Action - CCP Approval
- NA 833 (01/08) - Notice of Action - Child Care Change
- NA 834 (01/08) - Notice of Action - Child Care Denial
- NA 835 (01/08) - Notice of Action - Child Care Discontinuance
- NA 840A (10/03) - Notice Of Action - Determination Of Good Cause/No Good Cause
- NA 841 (10/06) - Notice Of Action - Welfare-To-Work Plan
- NA 960X QR (7/04) - Notice Of Action - Stop Aid; Report Not Received
- NA 960Y QR (7/04) - Notice Of Action - Stop Aid; Report Incomplete
- NA 993 (4/99) - Food Stamp Notice Of Discontinuance
- NA 995 (2/00) - Food Stamp Notice Of Denial/Disqualification For The California Food Assistance Program
- NA 1205 (11/99) - Notice of Action
- NA 1208 (2/00) - Notice Of Action - Basic Approval
- NA 1211 (2/00) - Notice Of Action - Denial
- NA 1212 (2/00) - Notice Of Action - Discontinue Property
- NA 1213 (2/00) - Notice Of Action - Discontinue Restricted Account
- NA 1214 (2/00) - Notice Of Action - Change Under/Overpayment
- NA 1215 (6/00) - Food Stamp Notice Of Change
- NA Back 9 - Your Hearing Rights
- PUB 13 (3/07) - Your Rights Pamphlet (Requires 8 1/2" x 14" paper printed landscape)
- PUB 244 (1/04) ESTABLISHING PATERNITY FOR YOU AND YOUR CHILD
- PUB 275 (1/04) - Family Planning - Making the Commitment for a Healthy Future
- PUB 337 (1/04) - Statewide Fingerprint Imaging System
- PUB 367 (01/04) - Reach For Your Dreams With Cal-Learn - This is a large PDF file. Please save it to your computer before opening and printing. For help with these files click here: Tips for Using Adobe PDF Files
- PUB 373 (Print 8 1/2 X 11) (5/07) - Important Food Stamp Information For Noncitizens
- PUB 373 (Print 11 X 17) (5/07) - Important Food Stamp Information For Noncitizens
- PUB 387 (01/04) - California Electronic Benefit Transfer (EBT) Card - The easy, safe, and convenient way to receive your food stamp benefits. - This is a large PDF file. Please save it to your computer before opening and printing. For help with these files click here: Tips for Using Adobe PDF Files
- PUB 388 (1/04) - California Electronic Benefit Transfer (EBT) Card - The easy, safe, and convenient way to receive your food stamp and cash benefits . - This is a large PDF file. Please save it to your computer before opening and printing. For help with these files click here: Tips for Using Adobe PDF Files
- PUB 389 (01/04) California Electronic Benefit Transfer (EBT) Card- How To Use Your EBT Card To Make A Purchase. This is a large PDF file. Please save it to your computer before opening and printing. For help with these files click here: Tips for Using Adobe PDF Files
- PUB 390 (1/04) California Electronic Benefit Transfer (EBT) Card- How To Use Your EBT Card To Buy Food. This is a large PDF file. Please save it to your computer before opening and printing. For help with these files click here: Tips for Using Adobe PDF Files
- QR 2 (06/04) - Reporting Changes For Your Cash Aid Assistance Unit And Food Stamp Household
- QR 3 (7/06) - Mid-Quarter Status Report For Cash Aid And Food Stamps
- QR 7 (04/03) - Quarterly Eligibility/Status Report
- QR 7 Addendum (04/03) - Instructions And Penalties Quarterly Eligibility/Status Report
- QR 7A (04/03) - How To Fill Out Your QR 7 Quarterly Eligibility/Status Report
- QR 22 (12/06) - Sponsored Noncitizens Applying For Or Receiving Cash Aid And/Or Food Stamps
- QR 72 (12/06) - Sponsor's Quarterly Income And Resources Report
- QR 377.1 (4/04)- Food Stamp Notice Of Approval
- QR 377.2 (4/04) - Food Stamp Notice Of Expiration Of Certification
- QR 377.4 (1/04) - Food Stamp Notice Of Change For Quarterly Reporting Household
- QR 377.5 (2/04) - Food Stamp Mid-Quarter Status Report
- SAWS 1 (12/06) - Application For Cash Aid, Food Stamps, And/Or Medi-Cal/State CMSP
- SAWS 2 (7/07) - Statement Of Facts For Cash Aid, Food Stamps, And medi-Cal/34-County Medical Services Program (CMSP)
- SAWS 2A QR (1/07) - Rights, Responsibilities And Other Important Information For The Cash Aid and Food Stamp
- SOC 445 (6/99) - Medi-Cal Recovery For The Personal Care Services Program
- SOC 829 (3/08) In-Home Supportive Services Provider Direct Deposit Enrollment/Change/Cancellation Form
- SOC 831 (3/08)- IHSS Provider Letter
- SSP 4A (1/99) - Application And Verification For Special Circumstances Program
- TEMP 2166 (8/99) - Work Pays Notice - Recommended Form
- TEMP 2172 (9/99) - Notice of Action
- Temp 2173 (3/00) - New Cash Aid And Food Stamp Rules - Fingerprint Imaging And Photo Imaging
- TEMP 2175 (7/99) - Notice of Action
- TEMP 2177 (11/99) - CFAP Work Rule
- Temp 2179 (9/00) - Welfare May Owe You Money
- Temp 2181 (4/00) - Notice Of Action
- TEMP 2201 (07/02) - Cash Aid/Food Stamp Electronic Benefit Transfer - EBT Request For A Designated Alternate Card Holder/Authorized Representative
- TEMP 2202 (07/02) - Cash Aid/Food Stamp Electronic Benefit Transfer - EBT Service Reque
- TEMP 2203 (07/02) - Request For Cash Aid Electronic Benefit Transfer - EBT Exemption
- TEMP 2214 (01/05) - Additional Information About Electronic Benefit Transfer (EBT)
- TEMP 2215 (07/02) - Electronic Benefit Transfer (EBT) Important Information
- TEMP CA 600 (4/99) - Annual Review For Cash Aid And Food Stamps
- Temp CW 101 (1/99) - CalWORKs Immunization Rules
- Temp CW 101A (1/99) - Immunizations Currently Recommended For Children Under The Age Of Six
- Temp NA 821A (6/99) - Notice Of Action
- Temp NA 823A (6/99) - Notice Of Action
- TEMP NA 1232 (3/06) - Food Stamp Notice of Action - EBT Account
- TEMP NA 1238 (07/04) - Required Form - Substitute Permitted
- TEMP NA 1239 (3/04) - Food Stamp Notice of Approval/Termination Transitional Benefits
- TEMP QR 1 (8/03) - New Reporting Requirements For CalWORKs And Food Stamp Recipients
- Welfare to Work Handbook
- WTW 4 (7/99) Notice To Other Parent
- WTW 5 (5/99) Welfare To Work Program Notice
- WTW 8 (7/99) Student Financial Aid Statement - Welfare To Work Supportive Services
- WTW 9 (7/99) Welfare To Work Appraisal Appointment Letter
- WTW 10 (7/99) Request For Welfare To Work Third-Party Assessment
- WTW 27 (10/03) - Request For Good Cause Determination
- WTW 29 (9/03) - Plan To Stop A Welfare To Work Sanction
- WTW 31 (10/06) - Request To Stop A Welfare To Work Sanction