SI SF01415.190 California — Exhibits (RTN 01, 05/2015)

Exhibit 1 California State Supplement Lead Questions

    

   

Exhibit 2 — SSP-22

Front

   

Back

    

Exhibit 3 Restaurant Meals Allowance (RMA) Application

Click to view APPLICATION FOR CALIFORNIA RESTAURANT MEALS ALLOWANCE

      

Exhibit 4 — OSS B Denial Paragraphs

    

We checked to see if you could get extra money from the State of California in your Supplemental Security Income (SSI) payment because you told us you need help with your personal care. Based on information we received, you are not eligible for the extra money.

  

Why We Can’t Pay You More

    

To receive a higher state payment while you live in a relative’s home, you must both need and receive help in that home taking care of your personal needs. We verify this by asking your county welfare office to check your living arrangement. The county told us that you:

   

_______ Do not need any help with your personal care.

 

_______ Are not receiving any help with your personal care.

     

Because of this, we can’t pay you extra state money.

 

Things To Remember

   

If, at any time, you think you qualify for this extra payment, please contact us right away.