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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES CalWORKs EXEMPTION REQUEST FORM PLEASE PRINT YOUR NAME COUNTY USE ONLY ADDRESS STREET CASE NAME ZIP CITY CASE NO. You do not have to complete this form to get a waiver to the time limits. You may contact your worker to request a domestic abuse waiver. You will be told in writing whether or not you are exempt from the CalWORKs 48-month time limit You ma...
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What is calworks exemption request form?
The CalWORKs exemption request form is a document used to request an exemption from certain requirements and obligations of the CalWORKs program.
Who is required to file calworks exemption request form?
CalWORKs recipients who believe they meet the eligibility criteria for an exemption must file the CalWORKs exemption request form.
How to fill out calworks exemption request form?
To fill out the CalWORKs exemption request form, you need to provide your personal information, describe the reasons for requesting an exemption, and submit any supporting documentation that may be required.
What is the purpose of calworks exemption request form?
The purpose of the CalWORKs exemption request form is to give recipients the opportunity to request exemptions from certain CalWORKs program requirements and obligations, such as participating in work-related activities.
What information must be reported on calworks exemption request form?
The CalWORKs exemption request form requires you to report your personal information, including your name, address, and case number. You will also need to provide detailed information about the reasons for your exemption request, such as medical conditions or childcare responsibilities.
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