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STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COUNTY OF AFRESH OVERISSUANCE NOTICE FOR ADMINISTRATIVE ERRORS (AE) ONLY Notice Date Case Name : Number
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How to fill out a CalFresh overissuance notice:

01
Obtain the CalFresh overissuance notice form: The first step is to obtain the specific form for submitting a CalFresh overissuance notice. This form can typically be found on the website of your local county social services agency or through their office.
02
Retrieve the necessary information: Gather all the relevant information needed to fill out the form accurately. This may include your name, address, case number, and any additional details specifically required by your county.
03
Fill out the recipient information: Provide your personal information as requested on the form. Double-check the accuracy of your details to ensure there are no mistakes.
04
Indicate the reason for the overissuance: On the form, you will find a section where you need to specify the reason for the overissuance. Common reasons include changes in household income, household size, or the outcome of a recertification review. Clearly state the cause of the overissuance to help the authorities understand your situation better.
05
Calculate the overissuance amount: Determine the amount that was overissued to you by referring to the notice you received from the CalFresh program. This amount should be clearly stated in the notice. Make sure to accurately input this information on the form.
06
Provide any additional documentation: Check if there is a section on the form where you can submit any supporting documents related to your overissuance. If required, gather any evidence that can help support your claim and attach it to your completed form before submitting.

Who needs a CalFresh overissuance notice:

01
Individuals who have received excess CalFresh benefits: A CalFresh overissuance notice is required for individuals or households who have received more benefits than they were eligible for. This could be due to changes in circumstances, failure to report accurate information, or errors made by the CalFresh program.
02
Recipients who have been notified of an overissuance: If you have received a notice from the CalFresh program informing you of an overissuance, it is essential to respond by completing and submitting the overissuance notice form. Failure to do so may have consequences such as repayment requirements or program sanctions.
03
Those seeking to rectify an overissuance: If you believe the overissuance notice was issued in error or if you have valid reasons for disputing the overpayment, the overissuance notice form is necessary to rectify the issue. It allows you to explain the situation and provide any supporting documentation to support your claim.
Remember to always consult the specific instructions provided on the overissuance notice form for your county, as requirements and processes may vary.
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CalFresh overissuance notice is to report when a household has received more CalFresh benefits than they were eligible for.
The individual or household who has received more CalFresh benefits than they were eligible for is required to file the overissuance notice.
The overissuance notice can be filled out by providing accurate information about the overpayment, including amounts received and reasons for the overpayment.
The purpose of the overissuance notice is to recover the overpaid CalFresh benefits from the recipient.
The overissuance notice must include details of the overpayment, such as the amount received, reasons for the overpayment, and steps taken to prevent future overpayments.
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