Form Temp Na 1230 - Notice Of Action
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1
2NOTICE OF ACTION
STATE OF CALIFORNIA
HEALTH AND HUMAN SERVICES AGENCY
COUNTY OF
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
Notice Date :
Case
Name
:
Number
:
Worker
Name
:
Number
:
Telephone :
Address :
ADDRESSEE
Questions? Ask 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.
As of _______________, the county has approved your back cash aid
of $ __________.
HERE’S WHY:
A new law has told us to look at the citizenship of your child(ren) in a
new way. A child not born in the United States is a US citizen when:
•
at least one parent is a legal US citizen; and
•
the child is under the age of 18 years; and
•
the child is a legal permanent resident; and
•
the child is in the legal and physical custody of the parent; and
•
the rule for adopted children is met.
Your back cash aid is figured on the next page.
A check will be sent soon.
A check is enclosed.
You have an existing overpayment balance. Some or all of your
back cash aid was used to lower the overpayment amount.
If you get Food Stamps, we will count your back cash aid as a
resource.
You may get another notice from Food Stamps.
Rules: These rules apply. You may review them at your welfare
office: MPP sections 42-433.3.
Page 1 of ____
TEMP NA 1230 (1/02) RETROACTIVE APPROVAL - CHILD CITIZEN ACT OF 2000 (P.L. 106-395)
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