Application Process
The timeframe to process a CF Application
30 days
Bi-Weekly Conversion Factor
2.167
NOA
Notice of Action
A SAR HH must complete this every 12 months
CF RE
Statement of Facts for Medi-Cal
SAWS 2 PLUS
This determines the application date
The date we receive the signed application
Amount of LUA Deduction
$166
IRT
Income Reporting Threshold
If a customer applies on a SAWS1, you will offer this form to them at the end of the interview
Statement of Facts
Request for Verification
CW2200
If the HH's monthly housing costs plus utilities exceed their combined income and resources, the HH is eligible to this
Expedite Services
Standard deduction for a HH of 5
$254
MCE
Modified Categorical Eligibility
HH's have conferred MCE status if they are given the PUB275 and have income below this percent
200% FPL
Semi-Annual Report
SAR7
% of the FPL to under IRT
130%
WINS
Work Incentive Nutrition Supplement
We must confirm the customer received these when they applied and confirm they understand them
Rights & Responsibilities
Self Employment Worksheet
SU393
The form clerical completes and attaches to the CF App for you
HH Fact Sheet
Maximum Shelter Allowance Deduction
$712
SUAS
State Utility Assistance Subsidy
Any student who does not meet the eligibility criteria shall be considered this
An Excluded HH Member?
Customer's Hearing Rights
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