Mc 194 2026

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The document is a referral notice from the California Department of Health Care Services for clients applying for or receiving Medi-Cal, Food Stamps, or Cash Aid. It outlines the process for clients to obtain or verify their Social Security Number (SSN) with the Social Security Administration (SSA). The form includes instructions for the County Welfare Department and recipients, detailing necessary documentation and actions required to resolve SSN issues. It emphasizes the importance of having an SSN for eligibility in these programs.

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Click ‘Get Form’ to open the mc 194 in the editor.
In Part I, enter the complete county welfare office name and address in the designated brackets. This information is crucial for proper processing.
For Section B, provide the Social Security Office information, including the fax number if applicable. Ensure accuracy to avoid delays.
In Section C, fill out the recipient's details such as name, SSN, date of birth, and sex. Double-check these entries for correctness.
Complete Part II by entering the date received and results of referral as required by the Social Security Administration. Make sure to include any comments if necessary.
Finally, review all sections for completeness and accuracy before saving or exporting your filled form.

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