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 Chinese. 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: Who needs to fill out this form?
A: This form needs to be filled out by California residents who are applying for public benefits and are unable to provide proof of citizenship.
Q: What is the purpose of this form?
A: The purpose of this form is to declare that the applicant has made reasonable efforts to obtain proof of citizenship, but has been unsuccessful.
Q: Can I fill out this form in Chinese?
A: Yes, this form is available in Chinese for applicants who prefer to fill it out in that language.
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.