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STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCYCALIFORNIA DEPARTMENT OF SOCIAL SERVICESCalWORKs 48MONTH TIME LIMIT EXTENDER REQUEST FORM PLEASE PRINT YOUR Nye County USE ONLY ADDRESSCOUNTYSTREETZIPCITYCASE

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Download the PDF CalWORKs 48-month time form from the official website.

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Fill in your personal details, such as name, address, contact information, and Social Security number.

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Provide the required information about your employment history, including start and end dates and job positions.

07

Indicate your income sources and amounts for each month within the 48-month time period.

08

If applicable, provide information about any public assistance programs you have received during this period.

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Who needs pdf calworks 48-month time?

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The PDF CalWORKs 48-month time form is needed by individuals who are participating in the CalWORKs program and are required to report their employment, income, and public assistance history for a specific 48-month time period.

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What is pdf calworks 48-month time?

The 48-month time is the time limit an individual is allowed to receive cash assistance through the CalWORKs program.

Who is required to file pdf calworks 48-month time?

CalWORKs recipients are required to file the 48-month time form.

How to fill out pdf calworks 48-month time?

The form can be filled out online or submitted in person at the local CalWORKs office.

What is the purpose of pdf calworks 48-month time?

The purpose is to track the amount of time an individual has received cash assistance through the CalWORKs program.

What information must be reported on pdf calworks 48-month time?

Information such as income, household composition, and work activities must be reported.

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