Form Temp Cf 1468 - Calfresh Notice Of Change

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CALFRESH NOTICE OF CHANGE
STATE OF CALIFORNIA
COUNTY OF
HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
Notice Date :
Case
Name
:
Number
:
Worker
Name
:
Number
:
Telephone :
Address
:
(ADDRESSEE)
If you have any questions or want more information
about this action, please contact your worker.
State Hearing: If you think this action
is wrong, you can ask for a hearing.
The back of this page tells how. Your
benefits may not be changed if you ask
for a hearing before this action takes
place.
Here’s why:
CHANGE BENEFITS
State Law has changed. Effective April 1, 2015 individuals with prior
The County has approved CalFresh benefits for ________________.
felony drug conviction are eligible for CalFresh benefits.
NAME
If you think there is a mistake in the amount of your CalFresh
The size of your CalFresh household has changed from _________
benefits, or if you have problems other than with the new law you can
to __________.
Your CalFresh benefits have changed from
ask for a state hearing. The back of this notice tells you how.
$____________ to $ _____________.
TEMP CF 1468 (2/15) REQUIRED FORM

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