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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COUNTY CASE NAME CalWORKs 48-MONTH TIME LIMIT EXTENDER DETERMINATION DENIAL FORM CASE NO.
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The CalWORKs Extender Form is a document that allows recipients of the California Work Opportunities and Responsibility to Kids (CalWORKs) program to apply for an extension of their benefits beyond the usual time limit.
CalWORKs recipients who have reached their time limit for benefits and need to request an extension are required to file the CalWORKs Extender Form.
To fill out the CalWORKs Extender Form, recipients should provide their personal information, current household composition, income details, reasons for requesting an extension, and any supporting documentation as required. The form can be obtained from the local CalWORKs office or downloaded from their website.
The purpose of the CalWORKs Extender Form is to allow qualified recipients of the CalWORKs program to request an extension of their benefits when they have reached their time limit but still face barriers to self-sufficiency.
The CalWORKs Extender Form requires recipients to report their personal information, current household composition, sources of income, employment details, reasons for requesting an extension, and any additional information as requested by the form.
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