Soc 2298-2026

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The document is a Live-In Self-Certification Form for the In-Home Supportive Services (IHSS) and Waiver Personal Care Services (WPCS) programs in California. It allows providers to certify that their wages for providing care to recipients living in the same home will be excluded from federal taxes. The form includes instructions for completion and must be returned to the designated address.

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Click ‘Get Form’ to open the soc 2298 in our editor.
Begin by entering your Provider Name as it appears on your IHSS paperwork in the designated field.
Next, locate and input your Provider Number, which can be found on documents like the Provider Notification of Recipient Authorized Hours.
Enter the Recipient Case Number from your IHSS paperwork in the appropriate section.
Fill in the Recipient County of Residence, ensuring accuracy for proper processing.
Sign the form on the designated line to confirm your self-certification and provide the date of signature.
Review all entries for clarity and correctness before finalizing. Remember to use black ink if printing a hard copy.

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