Recertification Forms

[63-300.2]

The forms below must be used to complete a CalFresh RC.

The series of application forms that are used are based on the type of CalFresh household, whether the interview is to be conducted face-to-face or over the telephone.

For CalFresh only cases:

  • “Recertification for CalFresh Benefits” (CF 37)

For CalFresh and CalWORKs or GA or Medi-Cal combo cases:

  • “Application for CalFresh, Cash Aid, and/or Medi-Cal/Health Care Programs” (SAWS 2 Plus), and
  • “Rights and Responsibilities and Other Important Information” (SAWS 2A SAR)

AND

  • “Appointment Letter (GEN 102) or “CalFresh Recertification Appointment Letter” (CF 29),
  • “How to Report Household Changes” (CF 23 SAR), and
  • “Would You Like to Register to Vote” (SCD 508), and
  • “Your Rights Under California Law” (PUB 13), and
  • “Notice of Language Services” (GEN 1365), and
  • “Demographic Questionnaire” (CW 2223), and

FOR Regular CalFresh HOUSEHOLDS

  • “CalFresh Notice of Expiration of Certification” (CF 377.2), and

OR

FOR ESAP HOUSEHOLDS

  • “CalFresh Notice of Expiration of Certification for Households with only Elderly and/or Disabled Members” (CF 377.2B).

CalFresh RC Packets

The complete list of recertification packets can be obtained from the “List of All DEBS Forms” located on the Program Bureau page, Reference Materials under the “Quick Reference Guides” heading.

For information regarding the RC packet, refer to DEBS Common Place Handbook Section 3.4.

When recertification is processed by paper application, benefits must not be interrupted if forms are returned, except the application for RC (i.e., CF 37).