Form 11 44h hhsa 2026

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The document is an affidavit form (Form 11-44H) for individuals applying for assistance from the County of San Diego Health and Human Services Agency, specifically addressing their homeless living situation. It requires applicants to declare their current living conditions, including locations where they have been staying, any payments made for accommodation, and details about their meals.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your case name, case number, and worker number at the top of the form.
In the affidavit section, clearly state your name and affirm your living situation by checking all applicable boxes for where you have been staying.
If you are staying in a vehicle, trailer, or boat, specify whose it is. Provide details about any payments made for your living situation.
Fill in the street address of your current location or describe it using cross streets if no exact address exists.
Detail where you have been eating by listing your last five meals and their locations.
Finally, sign and date the form to declare that all information provided is true and complete.

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