Form Na 824 - Notice Of Action
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1
2NOTICE OF ACTION
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)
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
Welfare to Work
Cal-Learn
transportation has been
extended until ________________.
Nothing about your approved transportation has changed except
the date your payment ends.
Because the extension is less than 30 days, this is the only
notice you will get telling you about the extension.
Here’s why:
Your approved
Welfare to Work
Cal-Learn
activity
___________ is continuing.
You need the transportation to keep your job.
Other:
You can call your Welfare to Work/Cal-Learn worker if you think
this notice is wrong.
Rules: These rules apply. You may review them at your welfare
office: CalWORKs Implementation Guidelines, Sections VII & XII,
Welf. & Inst. Code 11323.2, 11323.4, 11322.9
Page 1 of ____
NA 824 (4/99) REQUIRED – SUBSTITUTE PERMITTED
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Parent category: Legal