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Get Dfa 303 - California Department Of Social Services - Dss Cahwnet
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How to fill out the DFA 303 - California Department Of Social Services - Dss Cahwnet online
The DFA 303 form is essential for individuals needing to request replacement benefits from the California Department of Social Services. This guide will provide you with step-by-step instructions to help you complete the form accurately online.
Follow the steps to fill out the DFA 303 form correctly.
- Click ‘Get Form’ button to obtain the DFA 303 form and open it in the editor.
- In Part A, select the appropriate box that describes your situation regarding the Electronic Benefits Transfer (EBT) card not being received or having been transacted by an unauthorized person. Enter your mailing address details accurately.
- In Part B, indicate if your request for replacement benefits is approved or denied. If approved, fill in the authorized replacement amount and the date of replacement. If denied, provide a clear explanation for the denial.
- In the signature field, sign your name to authorize the information provided. Ensure to also include the date on which you are signing the form.
- If the home address differs from the mailing address provided earlier, enter the updated details in the specified field.
- Part C requires you to acknowledge receipt of the form. Fill in the date and sign to confirm your awareness of the information provided.
- If applicable, describe any incidents regarding the loss of benefits or food destruction in the space provided. Be as detailed as possible to support your case.
- Finally, review all information for accuracy before saving your changes. You can then download, print, or share your completed DFA 303 form.
Complete the DFA 303 form online today for your replacement benefits.
Sworn Statement: There is no specific sworn statement form used by the county; however, all sworn statements must include: date, name of the person and/or organization that receives payment, the amount a household is paying or receiving, and they must be signed by the client.
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