Temp 2201-2026

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  1. Click ‘Get Form’ to open the temp 2201 in the editor.
  2. Begin by entering the 'Case Name' and 'Case Number' at the top of the form. This information is essential for identifying your application.
  3. In the section for 'Designated Alternate Card Holder/Authorized Representative', specify whether you are requesting a new card holder, changing an existing one, or removing access.
  4. Fill in the name and birthdate of the person you wish to designate as your alternate card holder or authorized representative. Ensure accuracy to avoid any issues.
  5. Review the certification statement carefully. By signing, you acknowledge that this person will have access to all your cash aid and food stamp benefits.
  6. Sign and date the form where indicated. The designated alternate card holder must also sign and date their section.
  7. Once completed, send or bring the form to your County Office for processing.

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CalFresh? Household Size*Maximum Income Level (Per Year)1$18,9542$25,6363$32,3184$39,0004 more rows
If you have any questions, please call the EBT Helpline at (877) 328-9677 or the DPSS Customer Service Center at (866) 613-3777. Download the DPSS Mobile App for Android and Apple to review recent EBT transactions, search for local ATMs that accept EBT, and find out surcharge amounts, if any, for a local EBT ATM.
If you do not report when your income is more than your households IRT limit you may get more benefits than you should. You must repay any extra benefits you get based on income you do not report. If you do not report on purpose to try to get more benefits, this is fraud, and you may be charged with a crime.

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Food stamps are more officially known as Supplementary Nutrition Assistance Program (SNAP) benefits and the temporary boost that was put in place during the pandemic was brought to a close during February 2023, meaning there are no extras in May 2023.
CalFresh? Household Size*Maximum Income Level (Per Year)1$18,9542$25,6363$32,3184$39,0004 more rows
Someone who you choose to act on your behalf with the Marketplace, like a family member or other trusted person. Some authorized representatives may have legal authority to act on your behalf.
An AR is an adult non-household member who is authorized to act on the households behalf to apply for CalFresh, complete work registration forms, complete reporting or use the Electronic Benefits Card to purchase the households food. The AR must be an individual.
The authorized representative can be anyone the applicant chooses to represent them. The local CalFresh office cannot force the CalFresh household to have an authorized representative. An eligible CalFresh household can also choose to have an authorized representative pick up its EBT card, and buy its groceries.

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