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STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES NOTICE OF FORM CHANGE NO. 05-116 DATE 09×01/2005 TO: FROM: County Welfare Director Supply Clerk /
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How to fill out 05116 date 09012005 to
How to fill out 05116 date 09012005 to:
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Start by writing the month abbreviation "09" for September.
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Then, write the day as "01" for the first day of the month.
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Finally, write the year "2005".
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