Get Ihss Transfer County

Completing the Ihss Transfer County form online is essential for users requesting the transfer of their In-Home Supportive Services. This guide provides clear, step-by-step instructions to help you smoothly navigate the process.

Follow the steps to complete the Ihss Transfer County form accurately.

1. Press the ‘Get Form’ button to retrieve the form and open it in your document editor.
2. In the first section, fill in the date alongside your new county to indicate your move. This should be the current date.
3. Provide the name of the new county you are transferring to next to 'TO: County of.'
4. Enter your full name and Social Security Number (SSN) in the respective fields.
5. Fill in your date of birth (DOB) accurately to ensure your identification is verified.
6. State your new address including the street or P.O. Box, city, and California zip code. This information is crucial for service allocation.
7. Include your phone number so that the receiving county can contact you as needed.
8. Indicate if you are an Income Eligible recipient by checking the appropriate box.
9. Fill in the name and phone number of your eligibility worker, as well as their EW code to maintain continuity in your support services.
10. List all documents included with the transfer letter, ensuring you attach forms such as SOC 293 and SOC 295 among others.
11. The county name responsible for your IHSS services until the discontinuance date must be filled in.
12. Sign the document and provide the contact information for additional queries.
13. Finally, the receiving county must sign and return a copy of this document confirming responsibility for your case.

Complete your documents online to ensure a smooth transfer of your In-Home Supportive Services.