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Contra Costa California Form 1127-A: What You Should Know

Warm. If you're a California Resident, for your records to be available when applying for CSP, the following  needs to be submitted:  A) Proof of residency (e.g., vehicle registration, house lease, utility bills)  (1) A certificate or other form of official identification that includes your name,  address, and date of birth that is issued by a government agency, by the State of California, or in  connection with the licensing or certification of a place of business (e.g., DMV's driver  licensing card, California Certificate of Motor Vehicle Registration).  B) A birth certificate issued by a government agency (issued after August 1, 2004).  C) A current copy of a current utility bill or other document that includes your  name, address, and date of birth.  NOTE: If you have been issued a temporary, canceled, or withdrawn birth certificate or  other document without your consent within the past seven (7) days, contact the birth  record keeping unit at the address listed in the application for a certified copy. Please note to  keep all AFC temperature logs and data files for three years. If you're a non-resident of California, for your records to be available when applying for  CSP, the following needs to be submitted:  1) Proof of California residence  a) A non-driver's ID that includes your name, address, and date of birth. A birth certificate or a  copy of a current utility bill that includes your name, address, and date of birth  is acceptable (if the bill includes your name and address). If you have not been issued an ICP, you will need to submit a copy of your  current driver's license or ID card (must show proof of residence).  If you had a birth certificate from any other state or country that has  an ICP in use in California, please contact your county health department or California Department of Motor Vehicles to see if you  C) A current copy of a current utility bill that includes your name, address, and date of  birth.  You may also submit a fee waiver and an approved application.  2) Copies of  Certified copies of your final  fraudulent application, including verification and/or appeal information, if any.

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