This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California.
The document is provided in Korean. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form DHCS0003?
A: Form DHCS0003 is the Affidavit of Reasonable Effort to Get Proof of Citizenship.
Q: What is the purpose of Form DHCS0003?
A: The purpose of Form DHCS0003 is to declare the efforts made to obtain proof of citizenship for benefits received in California.
Q: Who should use Form DHCS0003?
A: Form DHCS0003 should be used by individuals who are unable to provide documentation of their citizenship but have made reasonable efforts to obtain it.
Q: What are the supporting documents required with Form DHCS0003?
A: Supporting documents required with Form DHCS0003 include copies of documents used to attempt to establish citizenship, such as birth certificates or naturalization papers.
Form Details:
Download a printable version of Form DHCS0003 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.