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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 SOC839
for the current year.
Form SOC839 In-home Supportive Services (Ihss) Designation of Authorized Representative - California
What Is Form SOC839?
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 Form SOC839?
A: Form SOC839 is the Designation of Authorized Representative form for the In-home Supportive Services (IHSS) program in California.
Q: What is the IHSS program?
A: The IHSS program is a California state program that provides in-home care services to eligible individuals who are aged, blind, or disabled.
Q: Why do I need to fill out Form SOC839?
A: You need to fill out Form SOC839 to designate an authorized representative who can act on your behalf for matters related to your IHSS benefits.
Q: Who can be designated as an authorized representative?
A: An authorized representative can be a family member, a friend, or any other trusted person who is willing and able to act on your behalf.
Q: What information do I need to provide on Form SOC839?
A: You need to provide your personal information, as well as the personal information of your authorized representative, including their name, address, and contact information.
Q: Do I need to notarize Form SOC839?
A: No, you do not need to notarize Form SOC839. However, you and your authorized representative must sign the form in the presence of a witness.
Q: How do I submit Form SOC839?
A: You can submit Form SOC839 by mail or in person to your local IHSS office. Make sure to keep a copy of the completed form for your records.
Q: Is there a deadline for submitting Form SOC839?
A: There is no specific deadline for submitting Form SOC839. However, it is recommended to submit the form as soon as possible to ensure that your authorized representative can assist you in a timely manner.
Q: Can I change my authorized representative?
A: Yes, you can change your authorized representative at any time by completing and submitting a new Form SOC839 to your local IHSS office.
Form Details:
- Released on June 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 SOC839 by clicking the link below or browse more documents and templates provided by the California Department of Social Services.
Download Form SOC839 In-home Supportive Services (Ihss) Designation of Authorized Representative - California
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