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Evidence Required
An Unrelated Adult Male (UAM) living in the home is considered a bona fide lodger, roomer, or boarder upon the Sworn Statement (GEN 853) of the mother to this effect, supported by evidence such as the following:
- 1040 tax return, indicating that income from the roomer and/or boarder is reported, or
- Possession of a license to operate a rooming house, or
- Evidence that quarters furnished are separate and apart from those occupied by the family, or
- Receipts which indicate payment of room rent and/or board.
Once the initial determination is made, additional verification is only required if there is substantial reason, which must be documented in the case record, to believe that the UAM is not a bona fide roomer and/or boarder.
Required Statement
[EAS 43-107]
A Statement of Cash Aid Mother and Unrelated Adult Male (UAM) (CW 71) signed by the CalWORKs mother and the UAM living with the family must be provided.
The CW 71 is required at intake, at redetermination, at the time of a restoration if a SAWS 2 is taken, and at any time the EW or client determines that there is a change in the family situation that might affect the UAM contribution. The recipient may submit an amended CW 71 for the current month if she decides to change her living or income arrangements. The CW 71 or SAR 7 are acceptable notifications of changes in the contribution. The actual contribution MUST BE reported on the SAR 7.
- The CW 71 is signed by the mother and the UAM under penalty of perjury. If either the mother or the UAM does not understand English, the CW 71 must be provided in a language that each understands, before it is signed.
- If the mother refuses to comply with the requirement to complete and sign the CW 71 , CalWORKs must be denied or discontinued. If she appears unable to comprehend or assist in establishing eligibility, action must be taken in accordance with EAS section 40-157.213.
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