§ 50159

Cal. Code Regs. tit. 22, § 50159

Statement of Facts.

State of California

(a) Following completion of the application form, a Statement of Facts shall be completed, signed and filed with the county department.
(b) The Statement of Facts shall be used by the county department in the determination of the applicant's:
1. (1) Eligibility.
2. (2) Share of cost.
3. (3) Other health care coverage.