Get Ca Soc 839 2023-2025

The CA SOC 839 form is essential for designating an Authorized Representative within the In-Home Supportive Services (IHSS) program. This guide will assist you in filling out the form accurately and efficiently to ensure a smooth application process.

Follow the steps to complete the CA SOC 839 online.

1. Click ‘Get Form’ button to access the CA SOC 839 form and open it in your preferred online editor.
2. Begin by entering the applicant's or recipient's name in the designated field. Ensure that the name matches what is on official documents.
3. Input the IHSS case number, which can be found on prior correspondence from the IHSS program, ensuring accuracy to avoid processing delays.
4. Provide the date of completion for the form to maintain an accurate timeline of your application.
5. Indicate who is completing the form by selecting either 'IHSS Applicant/Recipient' or 'Legal Representative,' and detail the relationship if a legal representative is designated.
6. Instruct filling out the Authorized Representative's details, including their name, address, email, state, zip code, telephone number, and spoken language.
7. Review the information entered to ensure that there are no errors or omissions, as missing information may prevent your form from being processed.
8. Both the applicant or their legal representative and the Authorized Representative must sign Part B of the form, confirming their understanding and agreement to the conditions listed.
9. If applicable, secure a witness or notary public's signature if the applicant cannot physically sign the form. Note that the Authorized Representative cannot act as the witness.
10. Once all steps are complete, save the changes to your form, then download, print, or share the document as needed before submitting it to the IHSS County Office.

Complete your CA SOC 839 form online today to ensure the timely designation of your Authorized Representative.