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Santa Clara County Social Services Agency wants to keep you safe & healthy.
Agencia de Servicios Sociales del Condado de Santa Clara quiere mantenerlo seguro y saludable.
Sở Xã Hội của Hạt Santa Clara muốn quý vị được an toàn va khỏe mạnh.
Lobbies are temporarily closed.
Recepciones temporalmente cerradas.
Sảnh chính tạm thời đóng cửa.
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PHONE | Por Teléfono | Điện thoại
1.408.758.3800
FAX | Fax | Điện thư
1.408.295.9248
Fax applications can be requested by calling - 1.408.758.3800
MAIL | Por Correo | Thư
PO Box 11018, San Jose, CA 95103
Mail applications can be requested by calling - 1.408.758.3800
Some information provided on your application may require additional documents be submitted. A County Eligibility Worker will let you know if any information needs additional documentation.
The following is a list of documents that could be needed to process your application.
Information
Commonly Used Verification Documents
Birth/Citizenship
- Birth Certificate
- US Passport
- Certificate of Naturalization
Identity
- Department of Motor Vehicles ID or Driver's License
- Work or School ID
- Passport
- USCIS (Immigration) Documents
Residency
- Department of Motor Vehicles ID or Driver's License
- Postmarked envelope or postcard addressed to you
- Utility Bill
- Rental Agreement
- Bill or other document with your name and address
Relationship
- Marriage or Domestic Partner Certificate
- Birth Certificate
- Court Papers (divorce, guardianship, etc.)
Social Security Number (SSN)
- Social Security Card
- Proof of application for SSN
Immigration Status
- Permanent Resident Card/Green Card (I-551)
- Employment Authorization Card (I-766)
- Foreign Passport with Form I-94/I-94A
- Notice of Action (I-797)
Earned Income
- Check Stubs
- Letter from employer with gross pay, hours worked, etc.
- Self-Employment Tax Forms (IRS Schedule C, etc.)
Other Income (Examples; SSA, Unemployment, Disability, Retirement)
- Benefits Award Letter
- Current Benefit Check
- School Grants/Loans/Financial Aid Statements
Property
- Bank Statements
- Vehicle Registration
- Mortgage Bills
- Property Deeds
- Life Insurance Policy, Stocks, Bonds, IRAs
- Most Recent Retirement Account Statements
Housing & Utility Costs
- Rental Agreement or Rent Receipt
- Mortgage Bill
- Utility Bill
- Property Tax Statement
- Home or Renter's Insurance Bills
- Hotel/Motel Receipt
Medical Costs
- Medical Bills or Receipts
- Medical Transportation Bills or Receipts
- Health or Dental Insurance Policies or Premiums
Medical Verification
- Proof of Pregnancy from Doctor/Clinic with Expected Due Date
- Doctor Statement
Immunization Records (for children under 6)
- Stamped Immunization Card
- Statement from parent or caretaker relative explaining why the child cannot be vaccinated
- Statement from doctor that immunizations are not available
Paper verifications will not be requested if the county already has current information or the information can be electronically verified. The County can help you get documents if necessary.
DEBS Ways to Apply rev 2
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Last updated: 6/5/2020 7:53 PM