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ALTERNATE PICK-UP REQUEST FORM

ALTERNATE PICK-UP REQUEST FORM 2026

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The document is an Alternate Pick-Up Request Form for the Emergency Food Assistance Program (EFAP) by the California Department of Social Services. It outlines the maximum income guidelines for households in 2016, specifies the authorization process for someone to pick up food commodities on behalf of an individual, and includes a certification statement regarding household income and usage of commodities.

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Click ‘Get Form’ to open the ALTERNATE PICK-UP REQUEST FORM in the editor.
Begin by entering the date at the top of the form. This helps track when the request is made.
In the 'Authorization' section, clearly write the name of the person authorized to pick up your EFAP commodities. Ensure this is someone you trust.
Next, indicate your household size and corresponding income by referring to the EFAP maximum income guidelines provided on the form. This ensures eligibility for assistance.
Complete the 'Certification' section by confirming that your household income does not exceed specified limits. This is a legal affirmation, so accuracy is crucial.
Finally, sign and date the form at the bottom to validate your request. Make sure all information is correct before submission.

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Versions	Form popularity	Fillable & printable
2023	4.2 Satisfied (51 Votes)
2018	4.6 Satisfied (53 Votes)
2016	4 Satisfied (25 Votes)

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