California Form Soc 450 PDF Details

The State of California, through its Health and Human Services Agency and the California Department of Social Services, facilitates a myriad of programs aimed at supporting residents in need. Among these tools for ensuring the well-being of its citizens is the SOC 450 form, a Voluntary Services Certification, which plays a pivotal role in the lattice of social services. This form is meticulously designed to structure the provision of voluntary services within the state, requiring clear information, including the names of the recipient and provider, recipient case number, contact details, and the specific services to be delivered. Notably, it emphasizes the volunteer nature of the service provision through its distinctive section wherein the provider acknowledges their right to compensation but opts to waive it or accept reduced payment. Moreover, vital for understanding the legal landscape of voluntary services in California, the form underscores identification verification purposes and references the Welfare & Institutions Code Section 12302.2, ensuring that all parties are aware of the legal foundation supporting these arrangements. This process not only promotes transparency and accountability but also encourages a structured volunteerism spirit within the state’s social services framework.

QuestionAnswer
Form NameCalifornia Form Soc 450
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names soc 450 499 form

Form Preview Example

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

VOLUNTARY SERVICES CERTIFICATION

(PLEASE TYPE OR PRINT CLEARLY)

RECIPIENT NAME

PROVIDER NAME

RECIPIENT CASE NUMBER

COUNTY

PROVIDER TELEPHONE NUMBER

PROVIDER SOCIAL SECURITY NUMBER

 

(OPTIONAL)*

 

 

PROVIDER STREET ADDRESS

CITY

ZIP CODE

SERVICES TO BE PROVIDED

DAYS AND/OR HOURS PER MONTH SERVICES

ARE TO BE PROVIDED

I agree to provide the above listed services voluntarily. I know that I have the right to be compensated but choose not to accept any payment, or reduced payment for the provision of these services

PROVIDER SIGNATURE

DATE

SOCIAL SERVICE WORKER SIGNATURE

DATE

*FOR IDENTIFICATION PURPOSES ONLY (AUTHORITY: WELFARE & INSTITUTIONS CODE SECTION 12302.2)

SOC 450 (4/99)

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1. Begin completing the California Form Soc 450 with a number of major fields. Note all the information you need and be sure nothing is overlooked!

Filling out part 1 of California Form Soc 450

2. After performing this part, go to the next part and fill in all required particulars in all these blanks - I agree to provide the above, PROVIDER SIGNATURE, SOCIAL SERVICE WORKER SIGNATURE, DATE, DATE, and FOR IDENTIFICATION PURPOSES ONLY.

California Form Soc 450 conclusion process detailed (stage 2)

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