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Action to households impacted by changes discussed in this letter. This form is a “master copy” only and is not stocked in the state warehouse.

Temp 2227 (See Attachment D) – This is an informing flyer to be used at application when the SAWS 2 and the SAWS 2A QR are used as application documents. The SAWS 2 and SAWS 2A QR will not be revised by October 1, 2006 due to other program changes taking place at the same time FSP changes are also needed. The Temp 2227 must be used until the SAWS 2 and SAWS 2A QR are revised to include new information about the SUA, LUA and TUA. This form is a “master copy” only and is not stocked in the state warehouse.

QR 3 – “Mid-Quarter Status Report” – A new section is added at the bottom of the page to include check boxes. Each box indicates the utility the household is paying. This form comes in “pads” and is stocked in the state warehouse.

QR 285B – “Food Stamp Budget Worksheet (Quarterly Reporting)” – This form is revised to delete the “Child Support Deduction.” This form is a “master copy” only and is not stocked in the state warehouse.

CAMERA-READY COPIES AND TRANSLATIONS

For a camera ready copy of English, contact the Forms Management Unit at (916) 657-1907. If your office has internet access, you may obtain these forms from the CDSS web page at: http://www.dss.cahwnet.gov/cdssweb/FormsandPu_271.htm. When all translations are completed per (MPP) 21-115.2, including Spanish forms, they are posted on an ongoing basis on our web site. Copies of the translated forms and publications can be obtained at: http://www.dss.cahwnet.gov/cdssweb/FormsandPu_274.htm. For questions on translated materials, please contact Language Services at (916) 651-8876.

If you have any questions regarding this letter, please contact Joyce Brewer, Analyst, Food Stamp Bureau, Policy Implementation Unit, at (916)654-3366 or via e-mail at Joyce.Brewer@dss.ca.gov.

Sincerely, Original Document Signed By:

CHARR LEE METSKER Deputy Director Welfare to Work Division Enclosures