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Get and Sign Soc 838  Form

Get and Sign Soc 838 Form

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AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES IN-HOME SUPPORTIVE SERVICES IHSS RECIPIENT REQUEST FOR ASSIGNMENT OF AUTHORIZED HOURS TO PROVIDERS RECIPIENT NAME PROVIDER NAME FIRST MIDDLE IHSS RECIPIENT CASE NUMBER LAST PROVIDER IDENTIFICATION NUMBER HOURS ASSIGNED PER MONTH I understand that by completing and submitting this form to the county In-Home Supportive Services IHSS program I am requesting the IHSS program to assign the indicated number of my authorized hours to the named provider....
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