Get Ca Soc 839 (sp) 2018-2026

The CA SOC 839 (SP) form allows users to designate an authorized representative for the In-Home Supportive Services program. This guide provides a detailed, step-by-step approach to help users easily complete the form online, ensuring that all necessary components are addressed.

Follow the steps to successfully complete the CA SOC 839 (SP) form online.

1. Click ‘Get Form’ button to access the CA SOC 839 (SP) form in the online editor.
2. Complete the section titled 'Applicant/Beneficiary Information' with the full name of the applicant or beneficiary, IHSS case number, and the date of filling out the form.
3. Move to PART A (Designation of Authorized Representative) and enter the name, address, and phone number of the designated authorized representative. Review PART B to understand the functions that can be performed by the representative.
4. Indicate whether the person designated in PART A has been convicted of Level 1 or Level 2 crimes within the last 10 years by selecting 'Yes' or 'No' for each question.
5. In PART B (Functions of Authorized Representative), check the boxes next to the functions you wish the authorized representative to perform, such as scheduling interviews or signing forms.
6. If necessary, proceed to PART C to designate someone else to sign reports on behalf of the applicant or beneficiary, providing their information as needed.
7. In PART D (Acknowledgment), sign and date the form, ensuring all details are accurate. If needed, arrange for a witness or notary public to sign.
8. Once all sections are completed and reviewed, save your changes. You can download, print, or share the completed form as required.

Start filling out your CA SOC 839 (SP) form online today to ensure proper care under the IHSS program.