CALFRESH HOUSEHOLD CHANGE REPORT (CF 377.5 CR) - cdss ca 2026

1. Click ‘Get Form’ to open the CALFRESH HOUSEHOLD CHANGE REPORT in the editor.
2. Begin with Section 1, 'Income Changes.' Indicate if there have been any changes in your household's income by answering questions A and B. If applicable, provide details in section C, including amounts and sources of income.
3. Move to Section 2, 'Household Composition Changes.' Answer questions regarding any new members or changes in your household. Provide names and relationships where necessary.
4. In Section 3, 'Resource Changes,' report if your total cash or assets exceed the specified limits. List each item and its amount.
5. Continue through Sections 4 to 9, providing information on ABAWD hours, address changes, child support payments, dependent care expenses, medical expenses for eligible members, and any temporary changes.
6. Finally, review all sections for accuracy before signing the certification at the end of the form. Ensure you understand the implications of misreporting.

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