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24 views

Reporting Change)

Report

Uploaded by

j34322998
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

066 Lincoln Heights COUNTY OF LOS ANGELES


4077 N MISSION RD
LOS ANGELES, CA 90032-2554
Date: 09/07/2024
Case Name: JOSELYN CARLOS
Case Number: L0BDA27
Worker Name: Customer Service
REPORTING CHANGES FOR CASH AID Worker ID: 19DP661E00
AND CALFRESH Worker Phone Number: (866) 613-3777

JOSELYN CARLOS
805 N SOTO ST APT 3
LOS ANGELES, CA 90033-1976

Because you get Cash Aid CalFresh, you must report within 10 days when your TOTAL income reaches a
certain level. You must report anytime your household’s total monthly income is more than your current Income Reporting
Threshold (IRT).

Benefit Type CalWORKs CalFresh


Family Size 1 1
Effective Month: 10/2024
Your Current Income $0.00 $734.00
Your IRT is $1,184.00 $1,184.00

Note: If your IRT for CalFresh is listed as "N/A", you are not required to report income changes for CalFresh until your next
SAR 7 or recertification, whichever comes first. However, if you have an IRT amount listed for CalWORKs, you must
report when your gross income goes over that amount.

How to report?
If your total income is over the IRT amount listed above, you must report this to the County within 10 days. You can report
this information to the County by calling the county or reporting it in writing.

By “total monthly income” we mean:


➯ Any money you get (both earned and unearned).
➯ The amount before any deductions are taken out. (Examples of deductions are: taxes, Social Security or other
retirement contributions, garnishments, etc.)

What will happen?


➯ Your benefits may be lowered or stopped based on income over your IRT.
➯ Your IRT may change when your income changes or when someone moves in or out of your home.

➯ The County will let you know in writing each time your IRT changes.

➯ You also need to report on your SAR 7 all income you get during the Report Month, even if you already reported that
money.

SAR 2 (6/19) Required Form - Substitutes Permitted

0000000524995889
Page 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

Penalty for not reporting


If you do not report when your income is more than your household’s IRT limit you might get more benefits than you should. You
must repay any extra benefits you get. If you do not report on purpose to try to get more benefits, this is fraud, and you may be
charged with a crime and/or may no longer get CalFresh for a period of time or life.

If you get Cash Aid, you MUST ALSO report the things below within 10 days of when they happen:

1. Anytime someone joins, or is in your household, who has been found by a court of law to be in violation of a condition of
probation or parole.

2. Anytime someone joins, or is in your household, who is running from the law (has a warrant out for their arrest).

3. Anytime you have an address change.

If you get CalFresh, you MUST ALSO report the following:


• If you are an Able Bodied Adult Without Dependents (ABAWD), you must report anytime your work or training hours
drop to less than 20 hours a week or 80 hours a month.

Voluntarily reporting information


You may also voluntarily report changes to the County anytime. Reporting some changes may get you more benefits. For
example:

• Your income stops or goes down.


• Someone with income moves out of your home.

• Someone without income moves into your home.


• Someone in the house becomes pregnant.
• Someone on cash aid has a special need, such as: a pregnancy, a special diet prescribed by a doctor, household
emergency, etc.
• The birth of a child.
• For CalFresh, if someone disabled or age 60 or older has new or higher out of pocket medical costs.

Note: Some changes you report voluntarily may result in a decrease in your CalFresh benefits.

For this form in large print or another format, please call your county.

SAR 2 (6/19) Required Form - Substitutes Permitted

0000000524995889
Page 2 of 2

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