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Printable Form SS-4 Visalia California: What You Should Know
Aid), dental assistance, medicaid (U.S. Code Title X), medical assistance (Medicare), social service assistance (Afresh or federal aid), or any of the California Health Services Program. About Initial Application for Cal Fresh, Cash Aid, and/or Medical — USDA Website Type or print clearly. 1 Application package for benefits. 2 Complete application (Form W-4). 3 All information needed for payment including Social Security Number (must be filled out). 5 Copy of SSN (includes W-4 number) and the information specified on the form on all pages including Title, address, taxpayer identification number, state, and zip. 12 Two (2) recent (within the last three (3) years) government-issued photos of parent (including one of mother and one of father) for children to be filed at birth. 14 Two (2) recent (within the last three (3) years) government-issued photos of other adult family members for children to be filed at birth. 15 Two (2) recent (within the last three (3) years) government-issued photos of adult family members. If you qualify you'll receive a letter requesting your birth certificate(s) within approximately two weeks of your filing. 18 About Application for Cal Fresh, Cash Aid, and/or Medical — Social Security Administration Website Type or print clearly. 1 Application package for benefits. 2 Complete application (Form W-4). 3 All information needed for payment including Social Security Number (must be filled out). 5 Copy of SSN (includes W-4 number) and the information specified on the form on all pages including Title, address, taxpayer identification number, state, and zip. 12 Two (2) recent (within the last three (3) years) government-issued photos of parent (including one of mother and one of father) for children to be filed at birth. 14 Two (2) recent (within the last three (3) years) government-issued photos of other adult family members for children to be filed at birth. 15 Two (2) recent (within the last three (3) years) government-issued photos of adult family members. If you qualify you'll receive a letter requesting your birth certificate(s) within approximately two weeks of your filing.
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