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Instructions for Form DHCS6065B Good Cause Certification - California
This document contains official instructions for Form DHCS6065B , Good Cause Certification - a form released and collected by the California Department of Health Care Services. An up-to-date fillable Form DHCS6065B is available for download through this link.
FAQ
Q: What is Form DHCS6065B?
A: Form DHCS6065B is a Good Cause Certification form used in California.
Q: What is the purpose of Form DHCS6065B?
A: The purpose of Form DHCS6065B is to certify that an individual has good cause for not meeting certain eligibility requirements for a state program.
Q: Who needs to complete Form DHCS6065B?
A: Individuals who are seeking an exemption from meeting eligibility requirements for a state program need to complete Form DHCS6065B.
Q: What information is required on Form DHCS6065B?
A: Form DHCS6065B requires information about the individual's personal circumstances and the specific eligibility requirements they are seeking an exemption from.
Q: How do I complete Form DHCS6065B?
A: Form DHCS6065B must be completed accurately and signed by the individual seeking the exemption.
Q: Are there any fees associated with submitting Form DHCS6065B?
A: There are no fees associated with submitting Form DHCS6065B.
Q: What should I do if I need help completing Form DHCS6065B?
A: If you need assistance or have questions about completing Form DHCS6065B, you should contact the appropriate county office or program application office for guidance.
Instruction Details:
- This 1-page document is available for download in PDF;
- Actual and applicable for the current year;
- Complete, printable, and free.
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the California Department of Health Care Services.
