Application Forms

[EAS 40-101.4]

The purpose of the application process is to assist the individual in establishing eligibility for aid and services. Intake EWs are required to explore eligibility for all programs requested and all benefits for which the applicant may qualify.

An application is a request for aid in writing made either by the applicant or another person, on behalf of the applicant, using one of the following forms:

Initial Application for CalFresh, Cash Aid, and/or Medi-Cal/Health Care Programs (SAWS 1)
Application for CalFresh, Cash Aid, and/or Medi-Cal/Health Care Programs (SAWS 2 Plus).

SAWS 1

The SAWS 1 can be used when a household is applying for CalWORKs or CalWORKs/CalFresh. The SAWS 1 is used to begin the application process and sets the beginning date of aid.

When the applicant’s signature has been obtained on the SAWS 1 to initiate the application process, information required on the Statement of Facts (SOF) should be completed during the interactive interview. The county should not send the SAWS 2 Plus to require another signature.

SAWS 2 Plus

The SAWS 2 Plus is a joint application for CalWORKs, CalFresh, and Medi-Cal. The SAWS 2 Plus replaces the SAWS 2 and combines the program rules, many of the rights and responsibilities, the SAWS 1, the SOF, and appendices to collect additional information where applicable. The SAWS 2 Plus must be completed in full prior to the applicant completing the signature page, as it is an attestation to the accuracy of the information.

Important: When the applicant cannot complete the full SAWS 2 Plus on the same day, either through an interactive interview, online via BenefitsCal, or hardcopy, counties may use the separate SAWS 1 to initiate the application and establish the beginning date of aid. For CalWORKs, this cannot be done by completing the “SAWS 1” portion of the SAWS 2 Plus. The separate SAWS 1 must be used.

Rules

The following rules apply when signing the SAWS 2 Plus:

The SAWS 2 Plus must be signed or recorded over the telephone and associated with their case number,
EACH question must be answered; if it is not applicable, they must enter “N/A,”
When both parents are in the home, the SAWS 2 Plus must be reviewed with both, and both parents must sign and date the SAWS 2 Plus, and
If the applicant/recipient changes the original answer, the change and initials must be in ink.
When concluding a telephone interview, the SOF (SAWS 2 Plus) must be provided to the applicant if the case has been approved. Refer to Chewable Byte 25-120: How to Generate SAWS 2 Plus Form with the Correct Case Data for CalSAWS instructions.

Use

There must be a separate SAWS 2 Plus (original) for each Assistance Unit (AU).

The SAWS 2 Plus is not designed for documenting subsequent changes in circumstances. Recipients are to use the Statement of Facts for an Additional Person (CW 8) or Statement of Facts to Add a Child Under Age 16 (CW 8A) for adding a person to the AU. Refer to Adding a Person to the AU.

A new SAWS 2 Plus is required for all:

Applications,
Restorations,
- Exception: When there is less than a one month break-in-aid. Refer to Restorations With Less than One Month Break-In-Aid.
RDs for cases with U-parent deprivation and for cases with earned income to the AU in the month the RD is conducted,
Incoming ICTs,
Changes from CalWORKs-FG to CalWORKs-U,
Changes from Transitional Medi-Cal (TMC), MNO, or Edwards v. Kizer Medi-Cal to CalWORKs, and
Significant change of circumstances which occur that may affect eligibility (i.e., change in caretaker relative from non-needy to needy).

A complete and signed SOF is required at every application and reapplication when benefits are approved.

Example 1Example 1 The applicant applied for CalWORKs in August and was approved. The SOF must be signed.

Example 2Example 2 The applicant applied for CalWORKs in August and was denied. The applicant reapplied in October and was approved. If the client signed a SOF for the August application, that SOF cannot be used for the October application. A new SOF must be signed.

Note: When the caretaker/relative changes from a needy caretaker to a non-needy caretaker or when there is a change of non-needy caretakers, the EW must determine continuing eligibility for the aided children. The EW may determine that the situation remains the same and that continued eligibility is evident. In this situation, at the face-to-face interview, the EW must secure a Non-Needy Relative Statement (SCD 345) and Child/Spousal and Medical Support Notice and Agreement (CW 2.1 N&A) if necessary, have the caretaker review, sign and date the Rights, Responsibilities and Other Important Information (SAWS 2A SAR), and document in the CalSAWS Journal Detail page, what has occurred.

SAWS 2A SAR

The Rights, Responsibilities and Other Important Information (SAWS 2A SAR) is a generic document with two signature pages. When both parents are in the home, the SAWS 2A SAR must be reviewed with both, and both parents must sign and date the SAWS 2A SAR.

The SAWS 2A SAR contains information on:

Applicant Rights and Responsibilities,
Work Registration and Training Rules,
The CalWORKs-U program,
CalFresh and Medi-Cal facts,
Intentional Program Violations (IPVs),
Homeless Assistance,
Maximum Family Grant (MFG, no longer applicable),
Maximum Aid Payments (Employable/Unemployable Amounts), and
CalWORKs 60-Month Time Limit.

Use

The SAWS 2A SAR must be completed when adding a parent or caretaker/relative and must be signed by both parents when both parents are in the home.

The SAWS 2A SAR is not necessary when:

The parent/caretaker relative has already signed a SAWS 2A SAR with the latest revision date, or
Adding a child to an existing AU.

Eligibility Worker Section

The EW must complete the Eligibility Worker section of the SAWS 2A SAR since it serves as county certification that the client has been informed of their rights and responsibilities.

When the EW generates the SAWS 2A SAR in CalSAWS, there is an automated journal entry with the following information:

Journal Category: All
Journal Type: Document
Short Description: SAWS 2A SAR - Rights & Responsibilities & Other Important Information
Long Description: Worker number and name
Date and time.

If the client signed the SAWS 2A SAR...

Then...

Electronically through CalSAWS (e.g., telephonic signature),

The automated journal entry is sufficient evidence that the EW completed the Eligibility Worker section.

Outside of CalSAWS (e.g., wet signature or DocuSign),

The EW must complete the Eligibility Worker section using a method such as a wet signature or DocuSign.

Note: The EW can sign and date the SAWS 2A SAR prior to the client signing it.

Intake Signature Packet

CalWORKs applicants are provided with a packet of required signature forms, which must be completed as part of the application process. The forms to be completed for the initial application include, but are not limited to:

SAWS 2 Plus/SOF
SAWS 2A SAR
CalWORKs Child Care Request Form and Child Care Payment Rules (CCP 7)
Would You Like to Register to Vote? (SCD 508).

Refer to Intake Packets on the DEBS Forms Library for a full list of forms in the Intake Packet.

Depending on each case's specific situation, additional forms listed in Case Record Forms may be required in the case record.

Reminder: If both parents are in the home, both parents must be interviewed and both must sign the SAWS 2A SAR and the SAWS 2 Plus or the appropriate SOF form.

Application Date

The date of the application for CalWORKs is the date that the written application for aid is received by the county. This date starts the 45-day application processing period. If the application is submitted without the client’s signature, the date of application will be the date the county obtains the client’s signature.

Note: Applications signed through the use of electronic signature techniques or applications containing a handwritten signature and then transmitted by fax or other electronic transmission are acceptable.