Applying for Cash Aid (Application and Forms)

CalWORKs Forms

There are various forms that may be needed when applying for CalWORKs. Below is a description of when each form is needed. 

• SAWS 2 PLUS, Application For CalFresh, Cash Aid, and/or Medi-Cal/Health Care Programs, is completed at Intake. You may complete the application in person, calling the Customer Service Center at (866) 613-3777, or online via the BenefitsCal website at: https://benefitscal.com. The SAWS 2 PLUS application is available in various languages.
  
  
• The SAWS 2A SAR (Rights, Responsibilities, and Important Information) form will be reviewed with your Eligibility Worker during the application interview via phone which must be signed after your application interview. The form will be mailed to you when you apply, but you can also print it from here, sign, and upload through BenefitsCal; mail to office; or drop it off at the district office by placing it in the drop box. 
  
  
• The following child support forms should only be completed when the Eligibility Worker has instructed you to do so. These forms can be printed, completed, and uploaded through BenefitsCal.
  
  CW 2.1 Notice and Agreement For Child, Spousal and Medical Support
  CW 2.1Q Support Questionnaire
  
  
• During the interview, you may be asked to complete the following forms as part of your application. They will be mailed to you when you apply, but you can also print, complete, and upload the forms through BenefitsCal.
  
  PA 129 Child Care – General Information
  GEN 853 (10/20)  – Sworn Statement
  PA 853-1 Affidavit To Document: U.S. Citizenship, Identity and Birth
  CSF 100 Confidential Domestic Violence (DV) Information
  
  
• When specific criteria are met, Immediate Need may be provided. Immediate Need is a cash benefit advance of the initial CalWORKs grant to applicant families which must be issued within 24 hours of being requested. You can use the form below to make an Immediate Need request as part of your application. Print, complete, and upload the form through BenefitsCal. 
  
  CW 4 Immediate Need Payment Request
  
  
• In the event you need to make a report of electronic theft of cash aid, the following forms in the language of your choice can be printed, completed, and uploaded through BenefitsCal.
  
  EBT2259 Electronic Theft of Cash Aid Form and Instructions
  EBT2259A EBT Scamming Acknowledgement