CalWORKs Policy - Department of Public Social Services

Agreement for Minor
Parent
CW 31, Receipt For
Documents
CW 42, Statement of
Facts for Homeless
Assistance
CW 51, Child Support-
Good Cause Claim for
Non-Cooperation
CW 60, Authorization to
Release Financial
Information
CW 61, Authorization to
Release Medical
Information
CW 61A, Physical
Capacities
CW 61B, Mental
Capacities
CW 82, Coversheet-
Agreement to Sell
Property
CW 86, Agreement-
Restricted Account
California Work
Opportunity and
Responsibility To Kids
Used to record the receipt of documents received
from applicants/participants.
Used to record the disposition of the request and to
track Homeless Assistance. It is to be completed by
each family requesting Homeless Assistance.
Used to document the
applicant’s/participant’s/beneficiary’s reason(s) for
claiming good cause (exemption) and provides the
Child Support Services Department (CSSD) and
DPSS a means of interdepartmental communication
regarding good cause (exemptions) and whether or
not child support/medical support enforcement may
subsequently proceed without the
applicant’s/participant’s/beneficiary’s participation.
Used to obtain information on an account(s) held by
an applicant/participant in a financial institution (i.e.,
banks, saving and loan associations, trust
companies, loan companies and credit unions).
This form is sent to Financial Institutions when the
applicant/participant cannot provide the financial
information necessary to determine eligibility or
when the information provided is contradictory or
inconclusive.
Used to obtain medical information on a CalWORKs
participant’s physical and mental incapacity.
Used to obtain information on the participant’s
physical condition to use in making decisions
concerning participant’s welfare-to-work
participation.
Used to obtain information on the participant’s
mental condition to use in making decisions
concerning participant’s welfare-to-work
participation.
Used to inform participants on agreement to make a
good faith effort to sell property.
Used to inform participants on Restricted Account
rules and regulations.