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LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH / REVENUE MANAGEMENT DIVISION Bulletin Knowledge is powers part of welfare reform in California, funds have been specifically budgeted for mental health
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How to fill out nga 13-004 verifying calworks
How to fill out nga 13-004 verifying calworks
01
To fill out NGA 13-004 verifying CalWORKs, you need to follow these steps:
02
Begin by entering the date at the top of the form.
03
Fill in the individual's full name, including first, middle, and last name, in the appropriate fields.
04
Provide the individual's social security number in the designated space.
05
Indicate the individual's current address, including street, city, state, and zip code.
06
Specify the county of residence in the designated field.
07
Enter the date of birth of the individual.
08
Fill in the individual's CalWORKs certification number, if applicable.
09
Indicate the name of the individual's employer, if currently working.
10
Provide the individual's work hours per week and wage rate, if applicable.
11
Tick the appropriate boxes to indicate if the individual is currently receiving CalWORKs cash aid and/or other benefits.
12
Sign and date the form at the bottom.
13
Make sure to review the completed form for accuracy and legibility before submitting it.
Who needs nga 13-004 verifying calworks?
01
NGA 13-004 verifying CalWORKs is needed by individuals who are receiving or applying for CalWORKs benefits. This form serves as a verification document to confirm eligibility and ensure accurate processing of the individual's benefits.
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What is nga 13-004 verifying calworks?
The NGA 13-004 form is used to verify participation in the CalWORKs program.
Who is required to file nga 13-004 verifying calworks?
Recipients of the CalWORKs program are required to file NGA 13-004 verifying their participation.
How to fill out nga 13-004 verifying calworks?
The form NGA 13-004 should be completed with accurate information regarding the recipient's participation in the CalWORKs program.
What is the purpose of nga 13-004 verifying calworks?
The purpose of NGA 13-004 is to confirm eligibility and continued participation in the CalWORKs program.
What information must be reported on nga 13-004 verifying calworks?
The form should include the recipient's name, case number, and details of their participation in the CalWORKs program.
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