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This version of the form is not currently in use and is provided for reference only. Download this version of
Form SOC839A
for the current year.
Form SOC839A In-home Supportive Services (Ihss) Cancellation of Authorized Representative - California
What Is Form SOC839A?
This is a legal form that was released by the California Department of Social Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is SOC 839A?
A: SOC 839A is a form used to request the cancellation of an authorized representative for In-Home Supportive Services (IHSS) in California.
Q: What is In-Home Supportive Services (IHSS)?
A: In-Home Supportive Services (IHSS) is a program in California that provides assistance with daily activities for elderly or disabled individuals who are unable to fully care for themselves.
Q: Who can use SOC 839A?
A: SOC 839A can be used by IHSS recipients in California who want to cancel their authorized representative.
Q: How do I fill out SOC 839A?
A: You need to fill out the recipient's information, the authorized representative's information, and provide a reason for the cancellation.
Form Details:
- Released on May 1, 2018;
- The latest edition provided by the California Department of Social Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form SOC839A by clicking the link below or browse more documents and templates provided by the California Department of Social Services.
