Follow these steps to fill out the self employment sworn statement using the FormsPal PDF editor:
Step 1: Click "Get Form Here" at the top of this page to open the form in the online PDF editor.
Step 2: Fill in your business name, type of business, and the date you started self-employment in the first section of the form.
Step 3: Report your total gross income for the month. Include all cash payments, product sales, and earnings from every source related to your business activity.
Step 4: List all allowable business expenses for the month. Common deductions include supplies, transportation for business purposes, phone costs, and wages paid to helpers.
Step 5: Enter the total hours you worked in the business during the month. Be accurate because county workers use this figure to verify your hourly rate.
Step 6: Sign and date the declaration at the bottom of the form. Your signature confirms that all reported information is accurate and complete.
Step 7: Click "Done" to download the completed form as a PDF. Print and sign if needed, then submit to your county social services office by the deadline on your notice.
What Is the CSF 35 Sworn Statement?
The CSF 35 is a California document that participants in CalWORKs, CalFresh, and Medi-Cal use to verify income from self-employment each month. County eligibility workers require the form whenever a participant's income changes or at scheduled review intervals.
The form takes about 10 minutes to complete when you have your income records and receipts ready. The net income figure you report determines how much your benefit payment will be reduced for the reporting month. If your business has a net loss in any given month, ask your county worker how losses affect your specific benefit case.
You may need related forms depending on your situation. The Self Employment Income Report provides a longer record of earnings over time. The Self Employment Form covers initial enrollment documentation. For sworn statement templates used in other states, see our Illinois Sworn Statement collection.
Common Questions About Completing This Form
Who must submit the CSF 35? Any CalWORKs or CalFresh participant who earns income from self-employment must submit this form monthly. This includes sole proprietors, independent contractors, home daycare providers, and gig economy workers.
What business expenses are deductible? You can deduct supplies, inventory, advertising, equipment rental, and transportation directly tied to the business. You cannot deduct personal expenses, one-time start-up costs, or capital equipment purchases on this form.
How do I handle multiple businesses? Complete a separate form for each business you operate. Attach all completed forms together when you submit to the county.
What if my income changes each month? Report actual income earned in that month. If your income is irregular, your benefit amount will be recalculated each month based on the figures you report on the form.
Where do I submit the completed form? Bring your signed form to your local county social services or Human Services Agency office. Some counties also accept submissions by mail or through their online participant portal.
