Form Cw 2222 - Calworks Employment Bureau - Request For Policy Interpretation

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State of California – Health and Human Services Agency
California Department of Social Services
CALWORKS EMPLOYMENT BUREAU
REQUEST FOR POLICY INTERPRETATION
INSTRUCTIONS: Complete items 1-10 of the form. Use a separate form for each policy interpretation
request. Retain a copy of this form for your records and submit via email directly to your Employment
Bureau county consultant. If your county consultant is currently a vacant position, send this form to
the Employment Bureau County Consultant Coordinator.
Please note: The policies expressed in this response are based on the unique set of facts presented
and should not be presumed to apply in other situations.
1. Requestor Name:
5. Date Of Request:
6. Need Response By:
2. Phone No:
Email:
7. Subject:
3. County:
8. References: (ACLs/ACINs, Court Cases, Etc.)
4. Regulation Citation(s):
9. Question/Background:
10. County’s Proposed Answer:
CW 2222 (11/17) Required Form - No Substitute Permitted
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