Form Na 279 - Notice Of Action - Excess Property (With Good Faith)
Download a blank fillable Form Na 279 - Notice Of Action - Excess Property (With Good Faith) in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Na 279 - Notice Of Action - Excess Property (With Good Faith) with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1NOTICE OF ACTION
COUNTY OF
STATE OF CALIFORNIA
HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
(Continued)
Notice Date
__________________________________________________________________________
Case
Name
__________________________________________________________________________
Number
__________________________________________________________________________
EXCESS PROPERTY
(WITH GOOD FAITH)
Cash Aid
Support Collection
Net Cash
Value of Property
Payment Month
Paid
by the County
Aid Paid
Over the Limit
______________
___________
_____________________
______________
_____________________
______________
___________
_____________________
______________
_____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
______________
$ ___________
_____________________
= ______________
$ _____________________
A.
Total Net Cash Paid
$ ______________
______________
B.
Highest Value of Property Over the Limit
$ _____________________
_____________________
C. The Smaller of A or B
$ _____________________
_____________________
Rules:
These rules apply; you may review them at your welfare
office. MPP 44-352.115
State Hearing:
If you think this action is wrong, you can ask for
a hearing. The back of page 1 tells how.
NA 279 (1/00) EXCESS PROPERTY (WITH GOOD FAITH)
Page _________ of ________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal