Fees Related To Requested Verifications

Fee-Exempt Birth Certificates

Per the CDPH, homeless individuals can request a certified copy of a birth certificate. Santa Clara County SSA is considered a homeless services provider. Therefore, in cases where any worker encounters a homeless client in need of obtaining a certified copy of a birth certificate, the worker must assist the client by completing an “Affidavit of Homeless Status for Fee Exempt Certified Copy of Birth Certificate.”

Federal Definition of Homeless

For the purpose of completing the Affidavit of Homeless Status, homeless is defined by 42 USC § 11302 as follows:

  • An individual or family who lacks a fixed, regular, and adequate nighttime residence; or
  • An individual or family with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings; or
  • An individual or family living in a supervised publicly or privately operated shelter designated to provide temporary living arrangements; or
  • An individual who resided in a shelter or place not meant for human habitation and who is exiting an institution where he or she temporarily resided; or
  • An individual or family who:
    • Will imminently lose their housing, including housing they own, rent, or live without paying rent, are sharing with others, and rooms in hotels or motels, as evidenced by:
      • A court order resulting from an eviction action that notifies the individual or family that they must leave within 14 days; or
      • The individual or family having a primary nighttime residence that is a room in a hotel or motel and where they lack the resources necessary to reside there for more than 14 days; or
      • Credible evidence indicating that the owner or renter of the housing will not allow the individual or family to stay for more than 14 days, and any oral statement from an individual or family seeking homeless assistance that is found to be credible shall be considered credible evidence for purposes of this clause;
    • Has no subsequent residence identified; and
    • Lacks the resources or support networks needed to obtain other permanent housing.

Affidavit Instructions

The “Affidavit of Homeless Status For Fee Exempt Certified Copy of Birth Certificate” is a state form, assigned SCD 2435, and is processed the same as sworn statements when applicant signs under penalty of perjury. The affidavit is completed as follows:

  1. The Client informs any SSA staff of need to obtain a certified copy of a birth certificate.
  2. The SSA Staff:
    1. Identifies client as having a need to obtain a certified copy of a birth certificate.
    2. Determines that client meets federal definition of homelessness.
    3. Accesses the affidavit (SCD 2435) on the DEBS Forms Library.
    4. Assists client in completing Section I of the affidavit, as needed.
    5. Completes and signs Section II of the affidavit:
    6. On the Entity Name of Homeless Services Provider Furnishing Verification of Homelessness line, enter “Santa Clara County Social Services Agency” and use the district office address.
    7. On the Signature of Agent for Provider line, provide signature and date.
  3. The Client:
    1. Signs the SCD 2435.
    2. Takes Affidavit to County Recorder’s office and completes application for birth certificate, per County Recorder’s policies and procedures

Frequently Asked Questions (FAQs)

Below are FAQs and answers:

Q1: Can someone make a request on behalf of another homeless person?

Yes, as long as the person is considered a homeless child or youth. A person (i.e., parent, guardian, legal guardian, grandparent, brother, sister, or government agency) may request a copy of a birth certificate on behalf of a homeless child or youth as long as they are lawfully entitled.

Q2: If a homeless person was not born in the county of search can counties charge a search fee?

No, counties may assist in searching for the record before the applicant makes a request.

HSC Section 103575 provides that the state or local registrar or county recorders, without a fee, verify date and place of birth, when the applicant presents sufficient information to identify the birth record. Counties may also refer applicants to the Quality Assurance and Intelligence Reform (QAIR) Section with the State Registrar at (916) 558-8116 to verify a county of birth. The homeless applicant should then contact the appropriate county to obtain the birth record.

Q3: Should county offices stamp birth certificates, “For Government Use Only?”

No, typically a homeless person, or homeless child or youth applicant would need to request a certified record of live birth for use in obtaining benefits and identification. Stamping “For Government Use Only” will limit the use of the certificate and will not be beneficial to the requestor or for the purpose of this legislation.

Q4: What are the guidelines for out of state requests?

The guidelines are the same as in California requests, but they must be born in California to benefit from AB 1733.

Q5: May an applicant request be mailed “care of” a government agency?

Yes, the completed request would be mailed back to the address indicated on the application.

No Fee Identification Cards

AB 1733 requires the DMV to issue at no fee, an identification card to individuals who provide proof of homeless status. AB 1733 is effective on January 1, 2016.

Requirements

Any homeless adult, child, or youth receiving public benefits may be eligible for a no-fee ID card from the DMV office. EWs will complete the “No Fee Identification Card Eligibility Verification” form (DL 933) upon request by homeless recipients. Eligible individuals must present the completed DL 933 card to the DMV, along with an Identification Card Application, for an ID card at no cost.

Reduced Fee Identification Cards

As part of the DMV’s implementation of AB 1733, there are also changes by the DMV to their Reduced Fee Identification Card Program and the “Verification for Reduced Fee Identification Card” form (DL 937).

Requirements

A person whose income meets the eligibility requirements of, or is receiving any of the public benefits listed below is eligible to receive a “Verification for Reduced Fee Identification Card” form (DL 937):

Note: The DL 937 may be completed for a Medi-Cal Only case when the income meets the eligibility requirements of the above programs.

“Verification for Reduced Fee Identification Card” Form DL 937

The “Verification for Reduced Fee Identification Card” form (DL 937) is a controlled form with unique serial numbers and printed on security paper. EWs will complete the DL 937 upon request. Eligible individuals must present the completed DL 937 card to the DMV, along with an Identification Card Application, for an ID card at no cost.

Related Topics

Employment, The Work Number, and Bank Verifications

Requests for Verification of Vital Records