CalWORKs is a California public assistance program that provides cash payments to low-income families with children. Benefits provide temporary financial aid to parents who are out of work, but are physically able to find new employment. In addition to monthly cash payment, CalWORKs provides job search and placement services. If you submit an application for CalWORKs benefits, but wish to cancel, you may request a voluntary withdrawal in writing. Contact your case worker and state you wish to cancel your application. Your case worker may request a letter from you, or request that you fill out state Form CW89.
List the date in the upper left corner of the page. Move two spaces below the date and write the name and office address of your case worker, if known.
Write a reference line one space below your case worker’s office address. The reference line must include your case number. For example, write “Re: Case Number.” This ensures the caseworker associates your letter with your file.
Write the opening salutation and body of your letter. An example of an opening salutation is “Dear” or “To Whom it May Concern” followed with the body one space below. The body of your letter must include a brief reason for your withdrawal from the CalWORKs program.
Write a closing salutation, such as “Sincerely,” followed by three spaces. Print your name and sign your name between the closing salutation and printed name.
Make a copy of the letter for your records and deliver your letter to your case worker. You may deliver the letter in person, or mail or fax to the contact information you have for your case worker. If you do not have an address or fax number to send the letter, contact your county Department of Social Services office and ask where to send the letter. Use certified mail if you plan on mailing it to ensure receipt of the document.
Print or download form CW89 for the California's Department of Social Services website. Write the date of your original application in the date box at the top of the form.
Check the “Cash Aid” box.
Write the reason you wish to withdraw your application in the space provided.
Answer questions regarding your decision to withdraw. Your answers to these questions should indicate that you voluntarily made the decision to withdraw, and that another person did not make the decision for you.
Sign and date the form. You must return the form to your case worker. If you decide to reapply in the future, you may do so.