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					Common-Place Handbook                                                         page 10-1

10. Verifications

10.1 Receipts Required by Law
    Senate Bill (SB) 1141 requires that Social Service Agencies provide a written
    receipt for documents hand delivered to the department to someone other than the
    regularly assigned worker, if the client requests it.

    • Receipts are required in the following programs:

         • CalWORKs, Refugee Cash Assistance (RCA)/Entrant Cash Assistance
           (ECA), Refugee Demonstration Project (RDP) and Foster Care (FC).

         • Medi-Cal

         • Food Stamps

    • Receipts are not required for documents that are mailed to the department.

    • Only one receipt is required for a hand-delivered QR 7 with its supporting

    • Posters shall be placed in a prominent place in the reception area of each district
      office informing the clients of their right to request a receipt.

10.1.1       “Receipt For Documents” (CSF30)

    The employee who receives the document is responsible to generate a receipt
    (CSF30) through CalWIN when one is requested. If more than one document of the
    same type (e.g., two social security cards) is received, additional information must
    be entered in the “Comments to Client/Other Documents Submitted” group box to
    clearly identify the documents submitted.

    The receipt must be printed and given to the client. A copy of the receipt MUST be
    attached to the documents and forwarded to the EW of record.

    [Refer to Record Receipt of Documents and Print Receipt in the CalWIN OLUM
    for step by step instructions.].

                                    Update # 08-20                          Revised: 01/13/11
page 10-2                                                        Common-Place Handbook
       The EW must:

       • Ensure the documents are scanned into the IDM system,

       • Return any ORIGINAL documents (i.e., Birth Certificate, Rental Agreement,
         Utility bill) to the client,

       • Burn Bag any copies of documents which have been scanned.

10.2 Computer-Generated Abstracts of Birth Records
       The California Department of Health, Office of State Registrar of Vital Statistics, will
       routinely fill requests for birth information with a computer-generated abstract for
       those records of births in California since 1905, other than those in Santa Clara

       • Abstracts are considered more “fraud-proof.”

       • Rather than abstracts, “regular” certified birth certificates may be obtained by
         indicating on the request that they are desired. The EW must indicate “regular”
         when submitting verification request to clerk.

           • Regular certificates are required to determine Indian heritage.

           • There is no extra cost for regular certificates.

       • Requesting procedures remain unchanged.

       [Reference: All County Information Notice (ACIN) #I-20-85 and #I-40-85]

10.2.1              What the Abstract Will Include

       The certified copy abstract will include the:

           •   Registrant's name
           •   Date of birth
           •   Sex
           •   County of birth
           •   Birth surname of mother
           •   Date issued
           •   Date filed
Revised: 01/13/11                        Update # 08-20
Common-Place Handbook                                                             page 10-3
         • State file number
         • Local file number

10.2.2        Security Features

    The certified copy of a birth abstract has the security features of bank note quality
    paper, including:

         • The fine-line lathe-work border design and state seal are printed by a deep
           intaglio (indented) steelplate process.

         • The border contains latent image letters “V” and “R” which are visible when
           the form is held at a prescribed angle while looking toward a light source
           (can't be seen on photocopies).

         • The background color is a fine line prismatic tint difficult to reproduce in
           normal photo and Xerox processes.

         • The inks are fluorescent and erasure-sensitive, making any attempt to erase
           or alter them very evident.

10.2.3        Providing Copies of Abstract

    Due to Senate Bill (SB) 247, it is a violation of State law to provide these copies to
    individual clients. Legislation went into effect July 1, 2003, requiring the County
    Recorder’s Office to issue two different types of certified copies to requestors.

    In an attempt to make identity theft more difficult, SB 247 requires that persons
    requesting certified copies of birth and/or death certificates sign a statement under
    penalty of perjury, that they are authorized to receive an authorized certified copy.
    Providing clients with these certificates circumvents this process.

    Government Agencies receive these documents for their use only. If Social
    Services no longer has a need for these certificates once they are scanned into the
    Integrated Document Management (IDM) system, they must be destroyed. By no
    means are these certificates to be given to the clients.

10.2.4        Children Under Six Months Old

    In June 2006, the Office of Vital Records with the State of California ceased
    providing birth certificates for children under six months old. The basis for this is
    due to a decrease in staffing, and their inability to keep up with the increased
    workload. The State Department has modified their policy to update their database
                                       Update # 08-20                           Revised: 01/13/11
page 10-4                                                                 Common-Place Handbook
       once newborns turn six months of age. Any requests sent to the State Department
       for newborns under six months of age will be returned indicating the request is “too

       In order for Social Services Agency clerical staff to avoid holding on to the request
       until the newborn turns six months of age, effective immediately, the “Application for
       Verification, Birth, Death, Marriage or Divorce To Determine Eligibility for Public
       Assistance Programs” (SC 58) will no longer be sent to the State Department Office
       of Vital Records for children under six months of age born outside of Santa Clara
       County. Instead, the SC 58 will be forwarded to the County Recorder’s Office or
       County Health Department in the county where the child is born.

           If the child is born in Santa Clara County, the six month time limit does not
           apply since requests will be sent to our local County Public Health

          Clerical staff is to forward the SC 58 to Accounts Payable, 333 W. Julian St.,
          2nd Floor. Accounts Payable will request the birth certificate from the
          appropriate source.

10.3 Requesting Certificates Within California
       Processes for the State of California are different than other states. When
       requesting a birth, death, marriage or divorce certificate within the State of
       California, the following must occur:

                    Who                  Action

                    Eligibility Worker   • Completes a “Clerical Check Sheet” (SC 109) indicating
                                           the certificate required.

                                         • Submits the SC 109 to clerical for processing.

                    Clerical             • Receives SC 109.

                                         • Completes SC 58 and submits to Accounts Payable.

                    Accounts Payable     • Receives SC 58.

                                         • Forwards request to Vital Records.

Revised: 01/13/11                              Update # 08-20
Common-Place Handbook                                                          page 10-5

10.4 Requesting Certificates Outside of California
    When requesting out of state certificates, in addition to the SC 58, clerical staff
    must also complete a separate form located on the State’s website and submit that
    form along with the SC 58 to Accounts Payable. Each state has their own form, and
    the forms may be located, as follows:

    • Clerical receives the SC 109 from the EW requesting an out of state certificate.

    • Go to

    • Click on States and Territories.

    • Click on the state from which you are requesting the certificate.

    • Scroll down the page to “Order Birth And Death Records On-line.” Click on “mail
      order” for the certificate you are requesting. Choices are: Birth, Death, Marriage
      and Divorce.

    • Scroll down the page and click on “Download Request For Certified Copy Of
      (Birth, Death, Marriage, Divorce) Record.”

    • Completes the SC 58.

    • Complete the state form and attaches it to the SC 58.

    • Submits both forms to Accounts Payable.

10.4.1      Photo IDs

    Many states now require that the requestor’s photo identification (ID) accompany
    their State form. States which require a government-issued photo ID accompany
    the request are as follows:

     ALASKA               ARIZONA                    COLORADO        CONNECTICUT

     FLORIDA              IDAHO                      INDIANA         IOWA

     KANSAS               LOUISIANA                  MARYLAND        MICHIGAN

     NEBRASKA             NEVADA                     NEW HAMPSHIRE   NEW JERSEY

                                    Update # 08-20                           Revised: 01/13/11
page 10-6                                                          Common-Place Handbook

           NEW MEXICO         NEW YORK                   NORTH CAROLLINA   OKLAHOMA

           OREGON             PENNSYLVANIA               RHODE ISLAND      SOUTH DAKOTA

           TENNESSEE          TEXAS                      UTAH              VIRGINIA


       The worker must submit a copy of his/her badge when requesting verification from
       these states. A copy of the badge must be submitted with the SC 109.

           Some states may require written permission from the client prior to obtaining
           the birth certificate (i.e., Pennsylvania).

10.4.2              Release of Information

       In addition to the employee ID, the following states also require an “Authorization to
       Release Information” (SC 1029) when requesting out-of-state birth certificates:

       •   Connecticut,
       •   Florida,
       •   Indiana,
       •   Louisiana, and
       •   Maryland.

10.4.3              Notarization of Application

       Minnesota and New York City require the application to be notarized, prior to
       accepting and processing the request. When a birth certificate is being requested
       from a state that requires the application to be notarized, the following must occur:

       • The website will indicate that the document must be notarized.

       • Clerical must complete the process as noted in Section 10.4 (and 10.4.1 and
         10.4.2, as appropriate).

       • Clerical must make an appointment with Collections via e-mail. A courtesy copy
         must be sent to Janet Cancilla, Paul Tran and Kent Maruyama. Once the
         appointment is scheduled, clerical must hand-carry the application to Recovery
         and Legal, which is located at 333 W. Julian St.

       • The application MUST be signed in the presence of the notary.

Revised: 01/13/11                       Update # 08-20
Common-Place Handbook                                                          page 10-7
    • Once notarized, the application must be submitted to Accounts Payable, which is
      located next door to Recovery and Legal, as noted in Section 10.4.

        Idaho also requires the application be notarized; however, the application
        MUST be notarized by the head of household. The State of Idaho will NOT
        accept applications notarized by County Employees.

10.5 Bank Verification

10.5.1      Requirement

    Bank of America requires that all requests for financial information be sent to a
    central location, rather than to the individual branch offices.

        Other financial institutions do not currently have this policy.


    The “Authorization for Release of Information - Financial Institutions” (CSF17) is to
    be used to request financial information on applicants and/or recipients.

10.5.2      Bank of America

    Bank of America is no longer completing account verification requests in their
    branch offices. If a CSF17 is sent to a Bank of America branch office, the bank will
    not forward it to the correct location. Instead, they will send a form back to the
    County with instructions on where the request is to be sent.

    In order to expedite processing of information requests, the full 10-digit Bank of
    America account number must be clearly noted on the CSF17.

    The CSF17 form is to be sent to:

         Bank of America, Credit Inquiry Services
         Social Svc. Unit, WA1-501-23-01
         P.O. Box 100289
         Columbia, SC 29202-3289
                                     Update # 08-20                          Revised: 01/13/11
page 10-8                                                       Common-Place Handbook

10.5.3              Wells Fargo Bank

       Wells Fargo Bank no longer processes verification requests received by mail. To
       avoid delays, all requests must be faxed to 1-336-796-8722. A request form and
       processing instructions can be found at

       When requesting verification from Wells Fargo Bank, it is important to remember
       the following:

       • All account numbers are entirely numeric. If the account number contains a
         alpha-letter, the request will not be processed.

       • The complete account number must be provided.

       • The authorization form must be signed and dated by the account owner, or the
         request will be returned.

       • All forms must be legible. Illegible forms will be returned.

       • Do not use a high-lighter. Highlighted areas turn the faxed copy black.

       All requests will be returned by fax to the return number listed on the request. In the
       event the fax is not successful, the request will be mailed to the address listed on
       the authorization form.

10.6 Employment Verification - The Work Number
       The Work Number is an agency contracted by employers to provide employment
       and wage verification to other agencies requesting this information. Information
       provided is based on the type of service contracted and paid for by the employer
       and is therefore limited. Companies that contract with The Work Number include
       Wal-Mart, Home Depot, K-Mart and Walgreens.

Revised: 01/13/11                       Update # 08-20
Common-Place Handbook                                                          page 10-9

10.6.1      Policy

    Verification received from The Work Number is treated in the same manner as
    information received from the employer. The applicant/recipient is the primary
    source of providing the agency with wage verification from their employer. The EW
    must contact the applicant/recipient to request additional information when there is
    a discrepancy or when incomplete information is received.

    Recipients who are employed with a company that contracts with The Work
    Number may have a problem obtaining their employment or income verification if
    they lose their payroll check stubs in a report month. In some cases, the recipient is
    at risk of being discontinued because of an incomplete QR 7. This is compounded
    when the EW tries to verify employment and wage data and it is not received or is
    inaccurate. The EW will continue to process the QR 7 as usual.

    The following are methods available to the EW to reconcile a discrepancy in wage
    verification received:

    • Contact the recipient to request additional information or records.

    • Contact the employer for the missing information.

    • Accept verification from The Work Number if provided by the employer or
      recipient. Workers may also contact The Work Number directly with a release of

    • Only after all efforts have failed and the information is unavailable, a “General
      Affidavit” (SC 101) completed by the recipient can be accepted. It must state that
      to the best of their knowledge, the information is true and correct. This
      declaration is signed under penalty of perjury. Accepting an SC 101 does not
      prevent the EW from completing a referral to the DA Investigators, Welfare
      Fraud Division when fraud is suspected.

        Include documentation in the case file of the attempt to verify the information.

10.6.2      IEVS Unit Usage of The Work Number

    The Work Number is a secondary source of verification that is used by the IEVS
    Unit in the Administrative Support Bureau.

                                     Update # 08-20                          Revised: 01/13/11
page 10-10                                                    Common-Place Handbook
       The Income Eligibility Verification System (IEVS) is the primary method of
       identifying unreported income. When data received from The Work Number does
       not match the IEVS ECS 155 report, or when accuracy of the information provided
       is questionable, or incomplete, assistance from the District Attorney (DA)
       Investigators is requested.

       There is no charge to Social Services Agencies to use The Work Number’s
       employment verification system via fax. Wage information available via fax may
       include the following.

       •   Social Security Number,
       •   Name,
       •   Start/Termination Date,
       •   Total time with employer,
       •   Income for previous two years,
       •   13 Pay-Periods,
       •   Year-to-Date information,
       •   Hours and gross wages, and
       •   Medical And Dental Insurance Information.

          District Line Staff may obtain wage information from The Work Number via fax
          when processing QR 7s.

              District Line Staff are NOT to use The Work Number’s on-line system, since
              there is a charge associated with the on-line system.

Revised: 01/13/11                       Update # 08-20

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