Get Ca Hhs Dcss 0230 2015-2025

The CA HHS DCSS 0230 form is essential for verifying wages and insurance for child support purposes in California. This guide will walk you through the online process of completing this form, ensuring all necessary information is provided clearly and accurately.

Follow the steps to successfully complete the CA HHS DCSS 0230 online.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. Fill in the CSE case number, participant name, and employer name at the top of the form.
3. In the employee/case participant identification and contact information section, provide the employee's name, social security number, date of birth, and address. Include a contact phone number.
4. In the employee work status section, check all applicable boxes regarding employment status—indicate whether the individual is currently employed, never employed, or no longer employed and provide relevant dates and employer details.
5. This section may also require the employer to indicate if there is an Income Withholding Order for support on file. Decide if the employee is single, married, or head of household and provide the number of dependents the employee claims.
6. Complete the employee earnings section with the next pay date, pay frequency, hourly rate, and deductions for mandatory retirement and union dues.
7. List the employee's earnings for the past 12 months or indicate if less than 12 months are available. Attach payroll earnings if necessary.
8. Next, proceed to provide health insurance information, detailing availability and cost for the employee and dependents, and policy information.
9. In the dependent information section, list all insured dependents. If more space is needed, attach an additional sheet.
10. Finish by completing the certification of record section, which includes printing the preparer’s name, signature, job title, and contact information. Sign and date the form.
11. After filling out all sections, ensure you save your changes. You can then download, print, or share the form as needed.

Complete your CA HHS DCSS 0230 form online today for efficient processing.