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Get CA SOC 829 2012

must submit an Enrollment/Change/Cancellation form with a check next to the box for Change or Cancel. You may access our website at www.dss.cahwnet.gov to download additional forms or contact the Direct Deposit Help desk toll free at (866) 376-7066. Please send your COMPLETED Enrollment/Change/Cancellation Form to: PROVIDER ENROLLMENT PROCESSING CENTER P.O. BOX 1120 ROSEVILLE, CA 95678 SOC 829 (10/11) .

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