Apply for Benefits
IN-PERSON
Monday - Friday 8:00am-5:00pm except for county holidays
Benefits Assistance Center – 1867 Senter Road, San Jose CA 95112
General Assistance Services – 1919 Senter Road, San Jose, CA 95112
North County Office – 1330 W. Middlefield Road, Mountain View, CA 94043
South County Office – 379 Tomkins Court, Gilroy, CA 95020
Fax*
1-408-295-9248
Mail*
PO Box 11018
San Jose, CA 95103
* Download an application below, call 408-758-3800 to get an application mailed or pick it up in one of our lobbies.
Need More Help
If you have a disability (physical, mental/emotional, or learning), you have the right to tell us how we can accommodate you.
Do any of these apply to you?
- Have a visual, hearing, or speaking impairment
- Need a language interpreter
- Have difficulty walking, sitting, or standing for a long time
- Need help filling out or understanding forms or complicated instruction
If you need help, inform a staff member.
You have the right to equal access to programs and services. If denied an accommodation, you may file a civil rights complaint or disability grievance with this office’s disability rights coordinator.
Tere Cohn-Hayes - Equal Opportunity Supervisor/Civil Rights Coordinator (408) 755–7299 | [email protected]
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.
Documents can be submitted:
- Online - Submit Documents Online
- Fax - 408-295-9248
- Mail - PO Box 11018, San Jose, CA 95103
- Drop Box at Office Locations:
Benefits Assistance Center – 1867 Senter Road, San Jose CA 95112
Continuing Benefit Services - 1877 Senter Road, San Jose CA 95112
CalWORKs Employment Services - 1879 Senter Road, San Jose CA 95112
General Assistance Services – 1919 Senter Road, San Jose, CA 95112
North County Office – 1330 W. Middlefield Road, Mountain View, CA 94043
South County Office – 379 Tomkins Court, Gilroy, CA 95020
Please include your name and case number on all submitted documents.
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