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Apply for public benefits

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. (408) 755-7999


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.
  • 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.
  • Please include your name and case number on all submitted documents.
Documents can be submitted


Fax: (408) 295-9248
PO Box 11018,
San Jose, CA 95103
Drop box at office locations 
listed in the contact information
at the top of this page.

The following is a list of documents that could be needed to process your application.

InformationCommonly used verification documents
  • Birth certificate
  • US Passport
  • Certificate of Naturalization
  • Department of Motor Vehicles ID or driver's license
  • Work or school ID
  • Passport
  • USCIS (Immigration) documents
  • 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
  • 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
  • Bank statements
  • Vehicle registration
  • Mortgage bills
  • Property deeds
  • Life insurance policy, stocks, bonds, IRAs
  • Most recent retirement account statements
Housing and 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