fa WILSHIRE SPECIAL OFFICE ‘As of 02/01/2018, the County's caging your CalFresh from § 68.00 to § 194.00. Here's Why When your income changes, your CalFresh benefits ‘amount also changes. COUNTY OF LOS ANGELES oy | STATE OF CALIFORNIA State Hearing: If you think this ention Is wrong, you can ask for a hearing, The back of this page tells you how. Your benefits may not be changed if 19 before this action takes you ask for a he Place. Monin Cairech Budgot auewerst REALTI aNO WELFARE AGENCY | Arete os serous vi owe | once pate Seach . Wonctiaie, Ar Teerrone wuwen: «= (eigaerasse GalFresh_NOTICE OF SAR CHCLE MIME Se goa | CHANGE FOR CHANGE i | REPORTING HOUSEHOLD | ANTOINE N SYVERAIN 1801 LAKESHORE AVE LOS ANGELES CA 90026 Coston? A Your Ware. | } ‘Your new CalFresh amount is figured on this notice, ‘Your CalFtesh household size is 01. Your IRT is: $1276.00, \ Roles: These rules apply: You may roview them al your weitare TDFAATT-A SAR (08) REQUIRED FORM-SUOSTITUTES PERMITTED I-l | Adjusthent for Cash Ati Penalles Report tient _February/2018 j Househol Seo 1 Reported Gross income (Actual) (rid Suppost Net Countabe Income ‘Alowabie Spenwes Housing( ua Standard Uilty Atowancs (SUA) Limited ty Atowance (LUA) Telephone Uy Alewarce (TUA) Depondont Cae Medics leavance Month February (2018, ‘Curent Month Aloteont {ese AlotnertRecuton Tolal Careah Aliment PAGE 10F 4