Arabic A-M

Arabic Translations Beginning With Letters A Through M

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Arabic forms beginning with the letters N through Z

For Arabic forms beginning with the following letters:

A | B | C | D | E | F | G | H | I | J | K | L | M

A

• ABCDM 229 (1/23) - Applicant/Recipient’s Authorization For Release Of Information To Community-Based Organization (CBO) In BenefitsCal
• ABCD 478A (5/20) - Disqualification Consent Agreement California Work Opportunity And Responsibility To Kids (CalWORKs) Program
• AD 100 (7/10) - Authorization For Use And/Or Disclosure Of Health Information Independent Adoption Program
• AR 2 SAR (3/15) - Reporting Changes For CalWORKs And CalFresh
• AR 3 (2/15) - Mid-Year Status Report For CalWORKs and CalFresh

C

• CCP 4 (8/21) - Health And Safety Self-Certification (For license-exempt providers)
• CCP 7 (10/19) - CalWORKs Child Care Request Form And Child Care Payment Rules
• CCP 8 (10/19) - CalWORKs Stage One Child Care Authorization Form
• CF 1 (10/14) - Notice To All CalFresh Recipients - Important Please Read
• CF 11 (9/22) - Notice To All CalFresh Recipients -  Important - Please Read - Use Starting October 1, 2022
• CF 11 (8/23) - Notice To All CalFresh Recipients - Use Starting October 1, 2023 
• CF 12 (6/23) - Notice to CalFresh Recipients
• CF 12 LP (6/23) - Notice to CalFresh Recipients - Large Print
• CF 18 (2/14) ENG/Arabic - Important Information
• CF 20 (2/14) - You Do Not Owe Anything For Receiving CalFresh Benefits
• CF 21 (3/14) - Release Form
• CF 28 Coversheet (2/14) - CalFresh Program Restricted Account Coversheet - Important To Know
• CF 28A (2/14) - CalFresh Program Restricted Account Agreement Part A
• CF 28B (2/14) - CalFresh Initial On-Demand Appointment Letter
• CF 29 (10/13) - CalFresh Recertification Appointment Letter
• CF 29A (2/14) - CalFresh Initial Appointment Letter
• CF 29B (2/14) - CalFresh Initial On-Demand Appointment Letter
• CF 29C (2/14) - CalFresh Recertification Appointment Letter
• CF 29D (2/14) - CalFresh Recertification On-Demand Appointment Letter
• CF 30 (2/18) - SAR 7 Reminder Notice
• CF 30 LP (2/18) - SAR 7 Reminder Notice - Large Print
• CF 31 (6/19) - CalFresh Supplemental Form For Excess Medical Deductions
• CF 32 (6/13) - CalFresh Request For Contact
• CF 34 (12/20) – CalFresh Notice of Change: Semi-Annual Reporting Eliminated
• CF 37 (11/16) - Recertification For CalFresh Benefits
• CF 100 (11/20) - CalFresh Request For Authorized Representative Drug Or Alcohol Treatment Center Resident
• CF 101 (11/20) - CalFresh Request For Authorized Representative
• CF 285 (8/21) - Application For CalFresh Benefits
• CF 285LP (4/21) - Application For CalFresh Benefits (20pt Font) - Use Starting June 1, 2019
• CF 285A (11/21) - Application For CalFresh Benefits
• CF 303 (8/19) – Replacement Or Disaster Supplement Affidavit
• CF 377.1 (5/20) - Notice Of Approval For CalFresh Benefits
• CF 377.1LP (5/20) - Notice Of Approval For CalFresh Benefits - Large Print 
• CF 377.1A (8/21) - Notice Of Denial Or Pending Status
• CF 377.10 (7/23) - CalFresh Notice Of Denial/Disqualification For Failure To Meet General CalFresh Work Rules
• CF 377.11 (6/18) - CalFresh Time Limit Notice - Failure To Meet The Able-Bodied Adults Without Dependents (ABAWDs) Work Requirement
• CF 377.11A (6/18) - CalFresh Time Limit Notice - Expiration Of Three Consecutive Months For Able-Bodied Adults Without Dependents (ABAWDs)
• CF 377.11B (6/18) - CalFresh Countable Month Letter - Use Of Countable Month For Able-Bodied Adults Without Dependents (ABAWDs)
• CF 377.11C (1/20) - CalFresh Informational Notice - CalFresh Time Limit For Able-Bodied Adults without Dependents (ABAWDs)
• CF 377.11D (1/20) – CalFresh Discretionary Exemption For Able-Bodied Adults Without Dependents (ABAWDs)
• CF 377.11E (1/20) – CalFresh Able-Bodied Adult Without Dependents (ABAWD) Time Limit Exemption Screening Form
• CF 377.2 (9/18) - CalFresh Notice Of Expiration Of Certification
• CF 377.2B (12/20) - CalFresh Notice Of Expiration Of Certification For Households With Only Elderly And/Or Disabled Members
• CF 377.2C (12/20) - CalFresh Notice Of Expiration Of Certification For Households With Only Elderly And/Or Disabled Members
• CF 377.2D (3/18) - CalFresh Notice Of Status Change For Households With Only Elderly And/Or Disabled Members
• CF 377.4 CR (1/14) - CalFresh Notice Of Change For Change Reporting Households
• CF 377.4 SAR (9/23) - CalFresh Notice Of Change For Semi-Annual Reporting Households
• CF 377.4A (2/14) - CalFresh Notice Of Change (Non-Citizen)
• CF 377.5 CR (11/13) - CalFresh Household Change Report
• CF 377.5 SAR (9/13) - CalFresh Mid-Certification Period Status Report
• CF 377.6 (8/13) - Information/Verification Needed
• CF 377.7A (2/14) - Notice Of Administrative Disqualification
• CF 377.7A1 (2/14) - Request For Restoration Of CalFresh Benefits After Administrative
• CF 377.7B (6/22) - CalFresh Overissuance Notice - Inadvertent Household Errors (IHE) Only
• CF 377.7B LP (6/22) - CalFresh Overissuance Notice - Inadvertent Household Errors (IHE) Only - Large Print
• CF 377.7B1 (6/22) - CalFresh Repayment Notice - Inadvertent Household Errors Only Final Notice
• CF 377.7B1 LP (6/22) - CalFresh Repayment Notice - Inadvertent Household Errors Only Final Notice - Large Print
• CF 377.7C (2/14) - CalFresh Repayment Agreement For Inadvertent Household Errors Only
• CF 377.7D (1/14) - CalFresh Overissuance Notice For Administrative Errors (AE) Only
• CF 377.7D1 (1/14) - CalFresh Overissuance Notice For Administrative Errors (AE) Only
• CF 377.7D2 (6/22) - CalFresh Repayment Final Notice - County Administrative Error (AE)
• CF 377.7D2 LP (6/22) - CalFresh Repayment Final Notice - County Administrative Error (AE) - Large Print
• CF 377.7D3 (6/22) - CalFresh Overissuance Notice For Administrative Errors (AE)
• CF 377.7D3 LP (6/18) - CalFresh Overissuance Notice For Administrative Errors (AE) - Large Print
• CF 377.7E1 (1/14) - CalFresh Repayment Agreement For Administrative Errors Only
• CF 377.7F (10/17) - CalFresh Overissuance Notice - Change From Inadvertent Household Error (IHE) To Intentional Program Violation (IPV)
• CF 377.7F LP (2/18) - CalFresh Overissuance Notice - Change From Inadvertent Household Error (IHE) To Intentional Program Violation (IPV) - Large Print
• CF 377.7F1 (10/17) - CalFresh Repayment Final Notice - Intentional Program Violation (IPV)
• CF 377.7F1 LP (2/18) - CalFresh Repayment Final Notice - Intentional Program Violation (IPV) - Large Print
• CF 377.7G (3/18) - CalFresh Intentional Program Violation (IPV) Notice - Due To Trafficking
• CF 377.7H (2/23) - CalFresh Informational Notice - Potential Intentional Program Violation (IPV)
• CF 377.9 (8/20) - Notice Of Back CalFresh Benefits
• CF 377.9LP (8/20) - Notice Of Back CalFresh Benefits - Large Print
• CF 385 (2/23) - Application For Disaster CalFresh
• CF 386 (2/14) - CalFresh Notice Of Missed Interview
• CF 387 (5/14) - CalFresh Request For Information
• CF 388 (8/13) - CalFresh Notice Of Restoration Approval
• CF 389 (2/14) - Notice Of Denial Of Restoration
• CF 478 (2/14) - Disqualifiction Consent Agreement CalFresh Program
• CF 1239 (12/20) - CalFresh Notice Of Approval/Denial/Termination Transitional Benefits
• CF 6177 (10/22) - CalFresh Student Exemption Screening Form
• CF SSA 1 (9/20) - Information For Households Applying For CalFresh With The Social Security Administration
• CF SSA 1LP (9/20) - Information For Households Applying For CalFresh With The Social Security Administration (20pt Font)
• CFAP 377.7B (8/23) – California Food Assistance Program (CFAP) - State CalFresh Overissuance Notice Inadvertent Household Error (IHE) - Use Starting October 1, 2025
• CR 6181 (11/20) - Interpreter Services Statement And Confidentiality Agreement
• CSFP 001 (7/22) - Commodity Supplemental Food Program (CSFP) Participant Application
• CSFP 006 (7/22) - Commodity Supplemental Food Program (CSFP) Notice Of Action
• CTRI 01 (10/20) - California Tax Return Information (CTRI) Notification To Client
• CW 8 (11/14) - Statement of Facts For An Additional Person
• CW 8A (12/14) - Statement Of Facts To Add A Child Under 16
• CW 42 (9/23) - Statement of Facts - Homeless Assistance
• CW 52 (7/18) - Changes To The California Work Opportunity And Responsibility To Kids (CalWORKs) Assistance Unit And Child Support Rules
• CW 52 (10/20) – California Work Opportunity And Responsibility To Kids (CalWORKs) Child Support Instead Of Cash Grant Option
• CW 63 (11/20) - Request For Income And/Or Resource Verification
• CW 80 (2/18) - Self-Certification Form For Motor Vehicles - CalWORKs
• CW 377 (2/23) - CalWORKs Informational Notice - Potential Intentional Program Violation (IPV)
• CF 889 (12/23) - CalFresh Restaurant Meals Program Approval/Termination Notice of Action
• CW 2166 (7/19) - Multilingual Work Really Pays! Here's How - Use Starting June 1, 2020
• CW 2166 (12/20) - Multilingual Work Really Pays! Here's How - Use Starting June 1, 2021
• CW 2166 (4/21) - Multilingual Work Really Pays! Here's How - Use Starting May 1, 2022
• CW 2166 (11/21) - Multilingual Work Really Pays! Here's How - Use Starting June 1, 2022
• CW 2184 (1/24) - CalWORKs 60-Month Time Limit - Use Starting October 1, 2024
• CW 2186A (4/21) - CalWORKs Exemption Request Form - Use Starting May 1, 2022
• CW 2186B (4/21) - CalWORKs Exemption Determination - Use Starting May 1, 2022
• CW 2187 (4/21) - Your CalWORKs 60-Month Time Limit - Use Starting May 1, 2022
• CW 2189A (9/20) – Notice Of Your CalWORKs Time Limit – 54TH Month On Aid (Use Starting May 1, 2022)
• CW 2189B (9/20) – Notice Of Your CalWORKs Time Limit – 57TH Month On Aid (Use Starting May 1, 2022)
• CW 2190A (4/21) - CalWORKs 60-Month Time Limit Extender Request Form - Use Starting May 1, 2022
• CW 2190B (4/21) - CalWORKs 60-Month Time Limit Extender Determination Form - Use Starting May 1, 2022
• CW 2191 (4/21) - Time On Aid Verification For CalWORKs/TANF 60-Month Time Limits - Use Starting May 1, 2022
• CW 2192 (4/21) - Tracking Non-California TANF Assistance For Time Limits - Use Starting May 1, 2022
• CW 2200 (6/19) - Request For Verification
• CW 2211 (11/14) - Your CalWORKs Reporting Rules Have Changed
• CW 2212 (11/14) - The Rules For Your CalWORKs Case Have Change
• CW 2213 (10/15) - Response To Request To Inspect Case Record CalWORKs, CalFresh, TCVAP, And Refugee Programs
• CW 2215 (10/20) - California Work Opportunity and Responsibility to Kids (CalWORKs) Important Information for Safety Net And Certain Child-Only Case
• CW 2218 (3/22) - Rights, Responsibilities And Other Important Information For The California Work Opportunity And Responsibility To Kids (CalWORKs) Program (Non-Needy Caretaker Relative With Relative Foster Child) - Use Starting June 1, 2022 

D

• DFA 377.1 (11/01) - Notice of Approval
• DFA 377.1A (3/02) - Notice Of Denial Or Pending Status
• DFA 377.7A (4/21) - Notice Of Administrative Disqualification
• DFA 377.7D2 (10/00 ) - Food Stamp Repayment Notice For Administrative Errors Only Final Notice
• DFA 377.7E (7/04) - Food Stamp Repayment Agreement For Administrative Errors Only
• DFA 377.7F (6/18) - CalFresh Overissuance Notice - Intentional Program Violation (IPV)
• DFA 377.7F LP (6/18) - CalFresh Overissuance Notice - Intentional Program Violation (IPV) - Large Print
• DFA 377.7F1 (10/00) - Food Stamp Repayment Notice For An Intentional Program Violation (IPV) Only Final Notice
• DFA 377.7G (5/02) - Food Stamp Repayment Agreement For An Intentional Program Violation (IPV) Only
• DFA 377.10 (6/04) - Food Stamp Notice Of Discontinuance
• DPA 19 (6/22) - Appointment Of Authorized Representative
• DPA 421 (7/99) - Notification Of Open Record And Waiver Of time
• DPA 435 (1/18) - County Allegation Of Intentional Program Violation/Statement Of Position (Request For An Administrative Disqualification hearing)
• DPA 436B (8/18) - County Information Letter
• DPA 479 (12/17) - Administrative Disqualification Hearing Waiver - CalWORKs/CalFresh

E

• EBT 1232 (6/22) - CalFresh Notice Of Action - EBT Account
• EBT 2216 (4/23) - EBT Surcharge Free - Direct Deposit Handout
• EBT 2259 (11/23) - Report Of Electronic Theft Of Benefits
• EBT 2259A (11/21) - EBT Scamming Acknowledgement
• EBT 2260 (8/21) - Excessive Card Replacement Warning Letter
• EFA 7 (7/21) - The Emergency Food Assistance Program (TEFAP) Certification Of Eligibility
• EFA 14 (3/23) - The Emergency Food Assistance Program (TEFAP) 2023 Income Guidelines
• EFA 15 (3/23) - Alternate Pick-Up Request Form The Emergency Food Assistance Program (TEFAP) 2023 Income Guidelines
• FDU 113 (7/22) - Civil Rights Annual Training Checklist For CSFP And TEFAP
• FSP 2 (1/21) - Family Stabilization Program Denial Notice - Use Starting May 1, 2022

G

• GEN 100 (11/20) - Examples Of Verification
• GEN 102 (1/22) - Appointment Letter
• GEN 111 (11/20) - Employer Statement Form
• GEN 853 (10/20) - Sworn Statement
• GEN 1179 (5/18) - Complaint of Discrimination
• GEN 1390 (3/17) - Informing Notice - Regarding An Action Taken On Your Case

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H

• HCS 100 (7/23) - Application For Home Care Aide Registration or Renewal

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L

• LIC 01A (6/23) - Resource Family Application
• LIC 126 (3/21) - Entrance Checklist - Family Child Care Homes
• LIC 184B (3/22) - Notification Of Incomplete Application - Family Child Care Home
• LIC 184C (3/22) - Notification Of Incomplete Application (NOIA) Child Care Centers - Pre-30-Day NOIA
• LIC 184D (3/22) - Notification Of Incomplete Application (NOIA) Child Care Centers - 30-Day NOIA
• LIC 184E (3/22) - Notice Of Incomplete Application (NOIA) Changes To Corporate Status
• LIC 198 (1/22) - Child Abuse Central Index Check For County Licensed Facilities
• LIC 279B (1/22) - Current Children In Your Home - Application For A Family Child Care Home License
• LIC 300A (01/22) - Removal Confirmation - Exemption Needed
• LIC 301E (10/22) - Reference Request - Exemption
• LIC 311A (2/22) - Records To Be Maintained At The Facility - Child Care Centers, Infant Centers, School-Age Centers and Child Care Centers For Mildly Ill Children
• LIC 311D (2/22) - Forms/Records To Keep In Your Family Child Care Home
• LIC 421A (6/22) - Civil Penalty Assessment (Unlicensed Facility)
• LIC 421CC (6/22) - Civil Penalty Assessment – Child Care
• LIC 421D (CC) (8/22) - Civil Penalty Assessment – Death/Serious Injury/Physical Abuse (Child Care)
• LIC 610A (01/22) - Emergency Disaster Plan For Family Child Care Homes
• LIC 613B (6/22) - Personal Rights Children’s Residential Facilities
• LIC 9052 (1/22) - Notice Employee Rights
• LIC 9058 (3/22) - Applicant/Licensee Rights
• LIC 9121 (7/21) - Facility Visit Checklist Family Child Care
• LIC 9217 (5/22) - Pre-Licensing Readiness Guide - Family Child Care Home

M

• M16-505A (7/02) - Designated Alternate Cardholder
• M16-705 (6/23) - EBT Adjustment Denial 
• M40-107 (4/21) - Addendum 1 - Child Support Collection For CalWORKs 60-Month Time Limit Exemption - Use Starting May 1, 2022
• M40-107 (4/21) - Addendum 2 - Child Support Collection For CalWORKs 60-Month Time Limit Exemption - Use Starting May 1, 2022
• M40-107A (4/21) - Time On Aid (no previous NOa issued), Other - Use Starting May 1, 2022
• M40-107B (4/21) - Time On Aid at Redetermination - Use Starting May 1, 2022
• M40-107C1 (9/20) - Time on Aid Between 54th and 57th Month - Use Starting May 1, 2022
• M40-107D (4/21) - Time On Aid To Former CalWORKs Recipients - Use Starting May 1, 2022
• M40-107F (4/21) - Extended Beyond 60 Months of Aid - Use Starting May 1, 2022
• M40-107F1 (4/21) - Extender Met After 60th Month - Use Starting May 1, 2022
• M40-107F2 (4/21) - Extender Ended - Use Starting May 1, 2022
• M40-107G (4/21) - 60th Month On Aid, Discontinue - Use Starting May 1, 2022
• M40-107I (7/22) - 60th Month On Aid, No eligible child, Discontinue
• M40-107J (4/21) - Timed-Out Adult, Partial Approval - Use Starting May 1, 2022
• M40-107J1 (4/21) - Approval After 60 Months on Aid - Use Starting May 1, 2022
• M40-107K (4/21) - Increase Grant due to TOA Adjustment - Use Starting May 1, 2022
• M40-129B (11/09) - Full Payment - Approve
• M40-129B1 (12/90) - Approval after Immediate Need Payment, Approve
• M40-129C (12/90) - Miscellaneous, Deny
• M40-129D2 (12/90) - Procedural Requirements, Deny
• M40-129D3 (12/90) - Procedural Requirements, Deny
• M40-129D4 (9/00) - Procedural Requirements, Deny
• M40-129D5 (11/14) - Failed to Provide Proof of SSN Application, Deny  
• M40-129E1 (12/90) - No Emergency, Deny
• M40-129E2 (12/90) - No Emergency, Deny
• M40-129E4 (12/90) - No Emergency, Deny
• M40-129E5 (12/90) - No Emergency, Deny
• M40-129E6 (12/90) - No Emergency, Deny
• M40-181 (9/13) - SAWS 2 Redetermination Of Eligibility
• M40-181C SAR (9/13) - Notice Of Action - Balderas Reminder Notice
• M40-181F (7/22) - No Change at Redetermination
• M40-181G (10/23) - Redetermination Reminder Notice
• M40-195B (8/22) - ICT Notice Of Transfer, Receiving
• M44-133T (9/20) - Minor Parent, Financial Eligibility, Partial Approval
• M40-195A (8/22) - ICT Notice Of Transfer, Sending
• M44-207K (5/20) – Financial Eligibility, Discontinue
• M44-207K1 (5/20) - Minor Parent, Financial Eligibility
• M44-207M (8/20) - Financial Eligibility, Deny
• M44-211D (9/23) - Temporary Shelter And/Or Permanent Housing
• M44-211L (9/23) - Pregnancy Special Needs, Approve
• M44-211N (9/23) -  Pregnancy Special Needs, Change
• M44-211O (9/23) - Discontinue Pregnancy Special Needs Payment for Pregnant Person Only Assistance Unit
• M44-315A (5/20) - $10 Minimum Payment, Change - Use Until April 30, 2022
• M44-315A (8/21) - $10 Minimum Payment, Change - Use Starting May 1, 2022
• M44-316 SAR (9/13) - No Change/Mid-Period Reporting
• M44-316A (9/13) - Notice Of Action - Not Yet Changed
• M44-316B (9/13) - Notice Of Action - Change In Income Over IRT
• M44-316C SAR (9/13) - No Change/Mid-Period Report of Property
• M44-316D SAR (9/13) - Notice Of Action - Change In Income
• M44-340 (2/23) - Underpayment Adjustment, Approval
• M44-350I SAR (9/13) - Notice Of Overpayment
• M44-350K (12/23) - EBT Replacement Denial
• M44-350L (12/18) - Notice Of Overpayment
• M44-352H (2/23) - Overpayment Adjustment 
• M44-352H SAR (9/13) - Notice Of Action Overpayment Adjustment
• M81-215E (4/21) - Time Limit Diversion - Use Starting May 1, 2022
• M81-215F (4/21) - Time Limit Diversion - Use Starting May 1, 2022
• M82-820A (9/21) - No Eligible Person, Deny
• M82-820D (9/23) - No Longer Eligible, Discontinue
• M82-832H (10/20) - Child Does Not Meet Requirements (SB 380)