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Ssp 14: What You Should Know

For Reimbursement Of Interim Assistance Posteligibility Case (SSP 14) — California Department of Social Services To receive an SSP 14, you must complete three steps: Claim For Reimbursement SSP 14 Form (SSP 14) Sign And File SSP 14 Reimbursement For Claim For Reimbursement SSP 14 (California) PDF form — Fill Io Complete Claim For Reimbursement Form and Sign SSP 14 (California) PDF form — Fill Io If you are entitled to SSI/APA, and you are not eligible for another SSI/SSP benefit at the same time, you may be able to continue your SSI/SSP benefits. If you are entitled to SSI/SSP, and you are receiving other benefits, this is an indication that your SSI/SSP claim and application is not filed in time and does not qualify for an SSI/SSP benefit. The SSP 14 will be used to determine what benefits you are eligible to receive. To complete the SSP 14 claim or posteligibility case form, you must bring the following, along with your SSP 14 authorization or an approved substitute form or two: Copy of all prior SSI/AS payments Copy of previous SSI/AS applications (if applied for during the last 12 months), if you received benefits while on Supplemental Security Income or Social Security Disability Insurance (SDI), and if your prior claims were not accepted Payment slips for all prior SSI/AS and SDI applications for the last twelve (12) months (if applicable) Is you have a substitute form, two (2) of the following documents must be included: A copy of the claim Form SSP 14 (SSP)14 or substitute from A copy of the prior SSI or SDI application (Copy of application(s) and Payment slips must accompany both requests (SSP14 form and prior SDI form) Pay-In-Kind Form In general, the SSP 14 form does not require any signatures/signatures must only include the following signatures: Signature(s) of the applicant(s) Copy of application form with signature of the applicant(s) If you receive any benefit to which you are not entitled, such as from Medicaid or Medicare, you must return this form to the State Social Services Agency within 15 days.

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