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STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES AFRESH HOUSEHOLD CHANGE REPORT (DFA 377.5) INSTRUCTIONS: Case Name: You must report changes within 10.
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Disqualification FAQ
CalFresh Eligibility Criteria Number of People in HouseholdMaximum Net Income Allowed5$2,7066$3,1007$3,4938$3,8865 more rows
Commonly Used CalFresh Forms 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.
You need to give the county a report about your income, assets and household every 6 months. If you start making more money, you might have to report right away. Income that is over the Income Reporting Threshold (IRT) will trigger a report.
YOUR INCOME REPORTING THRESHOLD (IRT)
How do I report changes to my income? If your income has decreased or stopped, you can upload proof of income for the last 30 days through getcalfresh.org/docs. Your county will give you more information about when you have to report increases in income.
CALWORKS IRT The IRT mandates when the AU is required to make a mid-period report of an increase in income, but the result of such a report is not necessarily discontinuance. Depending on how much income is reported, a report of income over the IRT could result either in a decrease in aid or discontinuance.
Your family can only get CalWORKs if it has $10,888 or less in resources ($16,333 if the family includes someone with a disability or someone 60 or over). CalWORKs does not count some things as resources: Your home. Household goods (like furniture or appliances)
Proof Needed to Get More CalFresh Benefits Housing costs (rent receipts, mortgage bills, property tax bill, insurance documents). Phone and utility costs. Medical expenses for anyone in your household who is elderly (60 and older) or disabled.
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