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Exemption/Extender Request Forms
“CalWORKs and Welfare-To-Work Time Limit Exemption Request Form” (CW 2186A)
The CW 2186A is a required form that must be given to a client when they indicate they may have a condition or circumstances that would prevent them from participating in CalWORKs Welfare-To-Work activities. The CW 2186A must be completed and signed by the client.
Note: Until the CW 2186A is revised by the State, please use the TEMP CW 2186A (10/09), which is available in the DEBS Forms intranet site.
“CalWORKs and Welfare-To-Work Time Limit Exemption Determination” (CW 2186B)
The EW will provide a CW 2186B to the client notifying them whether or not they are exempt from the time limits as they requested in the CW 2186A. The CW 2186B also indicates the exemption requested and if it has been granted or denied.
“County-Specific Exemption/Extender Review Form” (SCD 1725)
The SCD 1725 is completed by the CWES Worker and sent to the EW after the CWES Assessment Counselor Supervisor and or Program Unit have reviewed and approved the exemption/extender.
Exemptions/Extenders Known to the County
The EW shall not require a request form for an exemption/extender by the applicant or recipient if all of the required information to grant the exemption/extender is available to the county.
Related Topics
CalWORKs 60-Month Lifetime Limit
Determining Countable TANF Months from Another State
Monitoring Recipients Approaching Time Clock Limits
CalWORKs Individual Time Limit Exemptions
Extenders - After the 60-Month CalWORKs Time Limit
Out of State Inquiries- Closed Case