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GSA FORM 873 REV. 12/2004 This suggested form is for timekeepers to use in recording daily and bi-weekly pay and leave activity. Premium Pay hours include EDP Sunday Premium Night Differential and Overtime can be included. OTHER TYPES OF LEAVE CATEGORIES GSA FORM 873 BACK REV. U.S. GSA Form gsa-873 LEGEND Last day of month Holilday LEAVE EARNED H TOUR OF DUTY SUGGESTED CODES A Annual Leave M Military Leave LEAVE CATEGORY S Sick Leave E Excused R .

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File an appeal for more hours Request an appeal. Fill out the back of the Notice of Action form or send a letter to: ... Get everything in writing. You'll need written documentation from your client's doctor stating their needs and the type of care they require. ... Prepare for your hearing date. ... Attend the hearing. ... Get a decision.

Complete, sign and return the IHSS Program Provider Enrollment Form (SOC 426) directly to the County IHSS Office or IHSS Public Authority. For additional guidance, contact your County IHSS Office or IHSS Public Authority. Do not send the form to CDSS. Complete and sign the IHSS Provider Enrollment Agreement (SOC 846) .

You (or your authorized representative) must complete PART A of this form to let the county know who you have chosen to provide your authorized services. If you have multiple providers, you must fill out a separate form for each person who will be providing authorized services for you.

ing to state regulations, a parent can be an IHSS provider if “The parent has left full-time employment or is prevented from obtaining full-time employment because no other suitable provider is available and the inability of the parent to perform supportive services may result in inappropriate placement or ...

You must have a physician or other licensed health care professional fill out a Health Care Certification (SOC 873) form and you must return it to the county before care services can be authorized. You will be notified if your application for IHSS has been approved or denied.

IHSS is a program intended to enable aged, blind, and disabled individuals who are most at risk of being placed in out-of-home care to remain safely in their own home by providing domestic/related and personal care services.

The IHSS Program will help pay for services provided to you so that you can remain safely in your own home. To be eligible, you must be 65 year of age and over, or disabled, or blind. Disabled children are also potentially eligible for IHSS.

Toll Free Number (888) 944 – IHSS (4477) Local Number (213) 744 – IHSS (4477) OR....Print and mail to: DPSS In-Home Supportive Services. PO Box 93730. City of Industry, CA 91715-9608.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232