A form license 420 is a document that is issued by the state government to authorize an individual to engage in a specific activity. The form license 420 will list the specific activity that the individual is authorized to engage in, as well as any restrictions or conditions associated with that activity. It is important to note that a form license 420 is not a license to practice law, medicine, or any other profession. Rather, it is a document that authorizes an individual to engage in a specific activity without having to obtain a separate license from the state government. ........................................................................................... Form Licences 420 are issued by states as permission slips for certain activities- like owning weapons or fishing- often with restrictions and clauses attached. Recently however, due to relaxed marijuana laws in many states, Form Licence 420's have taken on another connotation; forms of government identification for peo
| Question | Answer |
|---|---|
| Form Name | Form Lic 420 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | lic420 form |
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
BUDGET INFORMATION
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING
FACILITY NAME |
FACILITY NUMBER |
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A.MEMBERS OF HOUSEHOLD (List all family members including foster children)
NAME
AGE
RELATIONSHIP
(USE ADDITIONAL SHEET IF NEEDED)
B.INCOME (Take Home Pay - Specify if Otherwise)
SOURCE |
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AMOUNT |
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$ |
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$ |
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Net Monthly Income |
$ |
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C. MONTHLY OUTGO |
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Loans (Mortgage Payments - Include Payments on All Property) and/or Rent |
$ |
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Utilities |
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$ |
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Transportation (car payments, gas, bus passes and car repairs) |
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$ |
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Food and Household Supplies |
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$ |
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Insurance Payment, Other than Payroll Deduction |
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$ |
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Other Expenditures |
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$ |
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CONTRACT PAYMENTS (List below, use additional sheet if necessary) |
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ITEM |
CONTRACT EXPIRES |
TOTAL OBLIGATION |
MONTHLY PAYMENTS |
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$ |
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$ |
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$ |
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Total Monthly Outgo |
$ |
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SAVINGS AND OTHER SOURCES OF INCOME: |
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REMARKS:
SIGNATURE
DATE PREPARED
LIC 420 (4/99)