State of California Noa Msg Doc No.: M40-181 Page 1 of 1

State of California Noa Msg Doc No.: M40-181 Page 1 of 1 Department of Social Services Action : Discontinue Issue: Application Processing Title: SAWS 2 Redetermination Of Eligibility

Auto ID No.: Use Form No. : NA 290 Source : Original Date : 05-01-13 New Issued by : ACL No. 13-80 Revision Date : 09-23-13 Reg Cite : 40-105.1, 40-181.2; .311

MESSAGE:

As of ______, the County is stopping your cash aid.

Here's why:

[ ] We have not received your annual redetermination of eligibility (SAWS 2).

[ ] We received your SAWS 2, but it was incomplete. It was missing: ______.

[ ] You did not complete your interview.

In order to stop this action, you must submit a complete SAWS 2 or call us to schedule an appointment before the end of this month. The information you give us may change or stop your benefits.

INSTRUCTIONS: Use to discontinue cash aid when the redetermination has not been received or is not complete. If the SAWS 2 was submitted, but was incomplete, specify what was incomplete on the report. This NOA message may be used under both SAR and AR/CO.