Form SOC 814 at a glance
What it is: SOC 814 is the Cash Assistance Program for Immigrants (CAPI) Application.
Who signs: An adult applicant, parent of a minor (under age 18), court appointed person or relative who is responsible for the care of the applicant, or an Authorized Representative if the county has written permission from the applicant on file.
To be eligible for CAPI a person must be a non-citizen and meet immigration status criteria (See Manual of Policies and Procedures (MPP) Section 49-020 “Immigration Status”), be a child under age 18 who is blind or disabled or be an adult who is blind, disabled, or 65 years or older, be ineligible for SSI/SSP solely due to immigration status, be a resident of California, and meet certain income and resource requirements.
What to bring and attach to Form SOC 814
The county will ask you to provide certain documents and evidence to determine if you (or the person you are applying for) are eligible for CAPI benefits. To save time, you can include this information with your application. You may be asked to provide the county with Identity/Immigration documents or records, evidence of your living arrangement (this can be a rental agreement, property deed, document from the facility you are staying at, or a signed note from the person you are staying with), checking or savings account statements if available (including on-line financial accounts), and paystubs or evidence of other types of earned and unearned income.
A filled-in Form SOC 814 example: an applicant fills in Section 1
How to fill out Form SOC 814, box by box
Section 1: Applicant information
Please print the answers clearly in blue or black ink.
If you answered “yes” to Are you hiding or running from the law for a felony, attempted felony, or a parole or probation violation? (Yes or No), go to the end of the application and sign your name.
“Homeless” means you do not have a regular place to sleep at night or you sleep in a temporary location such as a shelter or motel room or you sleep in a car, train or bus station, airport or abandoned building, you sleep outdoors, or you are temporarily “staying” with other people because you are unable to pay for your own place to live.
A response to the question What is your sex? is required from all applicants for cash aid. Your response is confidential.
More rules for Form SOC 814
One application is required for each applicant.
If you are answering questions on this form for someone else, including minors, please answer all the questions on this application about that person.
If you need more space to answer questions, use the ‘Remarks' area under Section 10.
You may also be required to attend a medical exam and/or provide your medical records if you are applying because of a disability. Failure to provide these documents and/or comply with these requirements may result in being denied for CAPI.
Receiving CAPI benefits may subject you to the federal public charge rule when applying for admission or adjustment of status, affecting your ability to obtain Lawful Permanent Residence.
If your situation is different
CAPI is a state-funded program for aged, blind, or disabled non-citizens who are ineligible for SSI/SSP solely due to their immigration status
CAPI is a state-funded program designed to provide monthly cash benefits to aged, blind, or disabled non-citizens only who are ineligible for Supplemental Security Income/State Supplementary Payment (SSI/SSP) solely due to their immigration status. Turn in this completed application to the county social services office. You can also call the county and apply over the phone.
If you are not currently married, go to Section 4
What is your marital status? If you are not currently married, please go to Section 4.
Are you a United States citizen?
Are you a United States citizen? (Yes or No) If you answered “yes” to the above, please go to page 24 (the end of the application) and sign your name.
If you have any documentation in your possession showing your current immigration status, application status, or knowledge of your presence/permission to reside in the United States, please include a copy with this application.
If you have a sponsor, Section 5: Sponsorship applies
Do you have a sponsor(s)? If you answered “no” to the above, please go to Section 6.
If your sponsor provides you with little or no support, or you do not reside with them, you may be eligible for an exception to the sponsor deeming rule. To apply for an indigence exception, complete form SOC 809 (CAPI Indigence Exception Statement).
Living arrangements in Section 7
Which of the following applies to your living arrangement (choose only one)? Own (Skip to Question 7-t); Rent - Live alone or only with my spouse and/or minor child(ren) (Skip to Question 7-t); Rent - Live with others (Continue to Question 7-g); Do not rent, but I contribute money (Skip to Question 7-t); Do not rent, and I live here for free (Skip to Question 7-t); Unhoused/Homeless (Skip to Section 8).
Do you buy most of your own food? (Note: If your only food comes from CalFresh/SNAP/CFAP and/or community resources such as food banks please mark “Yes”).
You will be asked questions about your total household expenses. Do not complete this section if you live alone or only with your spouse and/or minor child(ren).
Resources/Property and Income in Sections 8 and 9
Does your name or your spouse's name appear on the title of any vehicle? (Yes or No) Vehicles include cars, trucks, boats, motorcycles, motor homes, etc.
Signature: who may sign this application and the head of household
A person who signs an application on behalf of an applicant must give the county evidence of their authority to act on behalf of the applicant. If you are a person signing on behalf of the applicant, please sign your own name.
SIGNATURE OF HEAD OF HOUSEHOLD: If you pay expenses to another person in your household, the head of household must review Section 7 and sign this form. This section does not apply if you're the only person in your household, or if you only live with your spouse and/or minor child(ren).
Common questions about Form SOC 814
Is there a deadline?
You must tell the county about any changes listed under CHANGES YOU ARE REQUIRED TO REPORT within 10 days after the change occurs.
Is there a penalty?
I understand that anyone who knowingly lies or misrepresents the truth or arranges for someone to knowingly lie or misrepresent the truth is committing a crime that can be punished under state law.
What am I certifying when I sign?
“I declare under penalty of perjury that the information provided in this application and any statements or documents submitted in support of this application, is true and correct.”
When is this form not the right one?
United States citizens and undocumented immigrants are not eligible for CAPI benefits.
Sources
[1] Form SOC 814 (6/26), Cash Assistance Program for Immigrants (CAPI) Application, California Department of Social Services (the Official source link on this page).