SAR 7 Eligibility Status Report at a glance
What it is: The SAR 7 Eligibility Status Report is a California Department of Social Services form to keep your benefits coming.
Who signs: For CalWORKs or other cash aid, you and your aided spouse, registered domestic partner, or other parent (of cash-aided children) if living in the home sign; for two-parent households, a signature and date is required from both parents. For CalFresh, the head of household, a responsible household member, or the household's authorized representative signs.
A filled-in SAR 7 Eligibility Status Report example: a CalWORKs couple signs the report
How to fill out SAR 7 Eligibility Status Report, box by box
Sign and Date
Sign and Date: you need to sign and date this form, or it will be considered incomplete.
Sign on the Signature of the head of household, responsible household member, parent, caretaker, or authorized representative of the household line and enter the Date. Sign on the Signature of spouse, registered domestic partner, or other parent living in the home (if applicable) line and enter the Date. The Signature of witness to mark, interpreter, or other person completing form (if applicable) line and its Date are for that person, if applicable.
Remember to attach all proof if required, and all additional copies or extra pages. Contact your county if you need help, the county may be able to help you get proof if you need it.
More rules for SAR 7 Eligibility Status Report
You need to answer the Contact Information, Household Members and Income sections to keep your benefits.
Check ‘Yes' or ‘No' for each question. If you check ‘Yes' and had any changes, fill out the form with the changes about your household. If you check ‘No' for any question, you can move on to the next question.
If you need more space for your answers, or need to add more people or information in any of the sections, write on a separate sheet of paper and send the extra sheet of paper with your SAR 7 form.
All income includes earned (money from a job) and unearned (money you get that does not come from a job). Examples of unearned income can be unemployment benefits, Social Security, disability benefits, SSI/SSP, gifts, child support, or worker's compensation.
Resources include cash on hand, money in checking or savings accounts, stocks or bonds, land, or personal resources.
You do not have to answer the Disability questions, but they may help you get other services or help. If you check Yes, fill in the household member name (first, middle, last) and Explain.
Have your expenses changed is an optional question; your benefits will not stop if you don't answer this question.
If your address has changed, check Yes: you must report your new housing and utility expenses.
Dependent/Child Care: enter who paid for dependent/child care and the amount paid.
Child Support is asking if anyone in your household paid someone else not in your household for child support. Please provide proof if you have it.
Medical Costs applies to anyone in your household who is age 60 or older, or is disabled, and has new medical costs, a change in the amount of medical costs paid, or medical costs not reported before.
You need to answer the Gambling or Winning the Lottery question to keep your CalFresh benefits. Please send proof.
ABAWDs are persons aged 18-54 without dependent children. ABAWDs must meet the work requirement or be excused from meeting the work requirement to get CalFresh for more than 3 months.
This is an optional question. You do not need to answer this question, but it can help you keep getting benefits. For the person(s) listed, check all the boxes that apply; checking one or more boxes may help you to keep getting CalFresh.
Life Events: check all that apply for the situations that changed since you last reported, and send proof. Explain the change(s) in the space and send proof. You need to answer this section to keep your CalWORKs or other cash aid benefits.
No Changes: check this box if none of these happened to your household.
If your situation is different
You want your benefits to STOP
Stop My Benefits: you do not need to answer this question. If you want your benefits to STOP, check the box for the program that you want to stop, then sign and date the form and return it.
If you choose to STOP your benefits, you will get a notice telling you that your benefits have stopped.
Your contact information has changed since you last reported
If your contact information has changed since you last reported, check Yes and fill out the right side of the table with your new information.
Your household size has changed since you last reported
If your household size has changed since you last reported, or will change within the next six months, check Yes and fill in the household member name (first, middle, last), the date of birth, the relation to and what is the change.
Your earned or unearned income changed since you last reported
If your earned or unearned income changed since you last reported, or will change within the next six months, check Yes and fill in.
If you check No you still need to send proof of your income. If you don't have proof or need help getting proof, let the county know.
Your resources have changed since you last reported
If your resources have changed since you last reported, or you have new resources, check Yes and fill in, or check No. Fill in the household member name (first, middle, last), type of resource and value.
Vehicles are not counted for CalFresh. You do not need to report a change in vehicle or a new vehicle.
Anyone in your household currently has an outstanding felony warrant or has been found to be in violation of their parole or probation
Check Yes and fill in. You need to answer this question to keep your CalWORKs or other cash aid benefits.
Common questions about SAR 7 Eligibility Status Report
Can I fill out a SAR 7 form online?
Easy ways to submit your form and proof: online, visit www.BenefitsCal.com or scan the QR code.
Is there a deadline?
Please submit this form on time, by the 5th.
Where do I file it?
Easy ways to submit your form and proof: by mail, in the envelope that came with this form.
Is there a penalty?
If you don't report all facts or give wrong information on purpose about your income, property, or family status to get or keep getting aid or benefits, you can be legally prosecuted.
What am I certifying when I sign?
You declare under penalty of perjury under the laws of the United States and the State of California that the facts contained in this report are true, correct, and complete.
Sources
[1] SAR 7 Eligibility Status Report (12/23), California Department of Social Services (the Official source link on this page).
