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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 CalFresh Overissuance Notice:

01
Gather the necessary information: To fill out the CalFresh overissuance notice, you will need certain information such as your name, address, CalFresh case number, and the amount of overissuance identified by the county.
02
Review the overissuance notice: Carefully read and understand the overissuance notice provided by the county. It will contain details about the amount you owe and any instructions you need to follow.
03
Verify the accuracy of the overissuance amount: Double-check the amount of overissuance mentioned in the notice to ensure its accuracy. If you believe there is an error, contact the county immediately to discuss the discrepancy.
04
Determine your repayment options: The overissuance notice will outline the different repayment options available. Choose the option that suits your financial situation best, such as a lump sum payment or monthly installments. Be aware of any deadlines for responding to the notice.
05
Complete the repayment agreement form: If you choose to enter into a repayment agreement, fill out the provided form with accuracy. The form will ask for your personal information, the repayment option you have selected, and your signature as an agreement to repay the overissuance amount.
06
Submit the completed form: Once you have filled out the repayment agreement form, submit it according to the instructions provided in the notice. This may involve mailing the form or delivering it in person to the designated county office.

Who Needs CalFresh Overissuance Notice:

01
CalFresh recipients who have been identified as having received more benefits than they were eligible for may receive an overissuance notice. This situation can occur due to various reasons, such as changes in household income or household composition that were not timely reported.
02
Individuals or households who have been notified by the county that they have an overissuance and owe a specific amount of money are required to receive the CalFresh overissuance notice.
03
Those who have been enrolled in the CalFresh program and have experienced a discrepancy between the benefits they received and their eligibility criteria may need to receive and respond to a CalFresh overissuance notice.
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Calfresh overissuance notice is for reporting any discrepancies or errors in the amount of benefits received through the CalFresh program.
Individuals who have received benefits from the CalFresh program are required to file a calfresh overissuance notice if they believe there has been an error in the benefits amount.
To fill out a calfresh overissuance notice, individuals need to provide their personal information, details of the discrepancy, and any supporting documentation.
The purpose of calfresh overissuance notice is to ensure that individuals receive the correct amount of benefits through the CalFresh program.
The information that must be reported on calfresh overissuance notice includes personal details, the amount of benefits received, and the nature of the discrepancy.
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