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Attachment Agreement 086060 CDs/Orange County Board of Supervisors Page 1 of 16SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Agreement for Reimbursement to California's Interim Assistance
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How to fill out capi - california department

01
To fill out CAPI (California Department of Aging) application, follow these steps:
02
Obtain the CAPI application form from the California Department of Aging.
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Start by providing your personal information such as name, address, phone number, and date of birth.
04
Fill out the sections related to your household members, including their names, relationships, and income sources.
05
Provide information about your housing situation, including whether you rent or own, monthly rent/mortgage amount, and utility expenses.
06
Complete the section about your income and expenses, including any earned income, public assistance, and monthly bills.
07
If applicable, disclose any assets such as property, vehicles, or savings accounts.
08
Sign and date the application form.
09
Gather any necessary supporting documents, such as proof of income, identification, and residency.
10
Submit the completed application and supporting documents to the designated address provided by the California Department of Aging.
11
Wait for a response from the department regarding your CAPI eligibility.
12
Note: It is recommended to read the instructions accompanying the application form for any specific requirements or additional information needed during the application process.

Who needs capi - california department?

01
CAPI (California Department of Aging) is intended for individuals who meet the following criteria:
02
- Aged 65 or older, or blind, or have a disability.
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- Have limited income and resources.
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- Are legal residents of California.
05
- Are not receiving Supplemental Security Income (SSI) benefits, California State Supplemental Payment (SSP), or Aid to the Aged, Blind, and Disabled (AABD) cash assistance benefits from the county.
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CAPI stands for California Department of Aging and serves as a program designed to provide financial assistance to eligible individuals.
Individuals who are aged 65 or older, or disabled, and meet the income and asset requirements set by the California Department of Aging.
To fill out CAPI, individuals can submit an application through their local county social services agency.
The purpose of CAPI is to provide financial assistance to elderly and disabled individuals who are in need.
Information such as income, assets, age, and disability status must be reported on the CAPI application.
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