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STATEMENT OF CASH ADVANCE - AA190 STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES CONTACTS: EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMS COUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016 PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Alameda SHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016 ASSISTANCE PROGRAM FEDERAL STATE TOTAL CALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES, NONFEDERAL & TANF TIMED OUT ADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 780,928.00 2,535,383.00 3,316,311.00 CWKS Safety Net Asst SEP-16 MO 1,147,900.00 1,147,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 293,700.00 293,700.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 113,300.00 113,300.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 47,100.00 47,100.00 Total Advances 780,928.00 4,137,383.00 4,918,311.00 ADJUSTMENT FOR PRIOR PERIOD: Actual Expenditures CalWORKS Asst JUN-16 MO 1,168,406.00 2,641,271.00 3,809,677.00 CWKS Safety Net Asst JUN-16 MO 1,277,787.00 1,277,787.00 CWKS TANF Timed-Out Asst JUN-16 MO 328,227.00 328,227.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 126,343.00 126,343.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 52,301.00 52,301.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (896,036.00) (2,641,271.00) (3,537,307.00) CWKS Safety Net Asst JUN-16 MO (1,167,200.00) (1,167,200.00) CWKS TANF Timed-Out Asst JUN-16 MO (303,500.00) (303,500.00) CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (119,000.00) (119,000.00) CWKS Recent Non-Citizens Nonfederal JUN-16 MO (48,300.00) (48,300.00) Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 272,370.00 0.00 272,370.00 CWKS Safety Net Asst JUN-16 MO 110,587.00 110,587.00 CWKS TANF Timed-Out Asst JUN-16 MO 24,727.00 24,727.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 7,343.00 7,343.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 4,001.00 4,001.00 Total Net Adjustments 272,370.00 146,658.00 419,028.00 Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 272,370.00 146,658.00 419,028.00 MISC. ADJUSTMENT CWKS Monthly MOE Subaccount Est. SEP-16 MO (3,240,064.00) (3,240,064.00) CWKS Monthly MOE Subaccount Act. JUN-16 MO (2,693,956.71) (2,693,956.71) CWKS Monthly MOE Subaccount Est. JUN-16 MO 2,840,154.00 2,840,154.00 Family Support Subaccount JUL-16 MO (974,750.71) (974,750.71) Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 296,720.00 296,720.00 Family Support Subaccount FY14-15 Grow FY 2014-15 (481,039.98) (481,039.98) Child Poverty Subaccount Expenditure JUN-16 MO 602,442.00 602,442.00 Child Poverty Subaccount Recoup** JUN-16 MO (491,955.84) (491,955.84) 0.00 0.00 CWKS Recent Non-Citizens TANF Timed-Ou JUN-16 MO 1,702.00 1,702.00 CWKS Diversion Asst JUN-16 MO (562.00) 0.00 (562.00) CWKs ARC (MOE) JUN-16 MO 16,427.00 1,201.00 17,628.00 0.00 0.00 ARC Exp. JUN-16 MO (24,885.00) (24,885.00) EBT FS GA/GR APR-16 MO (9,121.60) (9,121.60) 0.00 0.00 Total Miscellaneous Adjustment 15,865.00 (4,173,554.84) (4,157,689.84) TOTAL 1,069,163.00 110,486.16 1,179,649.16 Sch No. 020527T COMMENTS: *Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion. **Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal. ***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

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STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: AlamedaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 780,928.00 2,535,383.00 3,316,311.00 CWKS Safety Net Asst SEP-16 MO 1,147,900.00 1,147,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 293,700.00 293,700.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 113,300.00 113,300.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 47,100.00 47,100.00 Total Advances 780,928.00 4,137,383.00 4,918,311.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 1,168,406.00 2,641,271.00 3,809,677.00 CWKS Safety Net Asst JUN-16 MO 1,277,787.00 1,277,787.00 CWKS TANF Timed-Out Asst JUN-16 MO 328,227.00 328,227.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 126,343.00 126,343.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 52,301.00 52,301.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (896,036.00) (2,641,271.00) (3,537,307.00)CWKS Safety Net Asst JUN-16 MO (1,167,200.00) (1,167,200.00)CWKS TANF Timed-Out Asst JUN-16 MO (303,500.00) (303,500.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (119,000.00) (119,000.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (48,300.00) (48,300.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 272,370.00 0.00 272,370.00 CWKS Safety Net Asst JUN-16 MO 110,587.00 110,587.00 CWKS TANF Timed-Out Asst JUN-16 MO 24,727.00 24,727.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 7,343.00 7,343.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 4,001.00 4,001.00 Total Net Adjustments 272,370.00 146,658.00 419,028.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 272,370.00 146,658.00 419,028.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (3,240,064.00) (3,240,064.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (2,693,956.71) (2,693,956.71)CWKS Monthly MOE Subaccount Est. JUN-16 MO 2,840,154.00 2,840,154.00 Family Support Subaccount JUL-16 MO (974,750.71) (974,750.71)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 296,720.00 296,720.00 Family Support Subaccount FY14-15 Growth FY 2014-15 (481,039.98) (481,039.98)Child Poverty Subaccount Expenditure JUN-16 MO 602,442.00 602,442.00 Child Poverty Subaccount Recoup** JUN-16 MO (491,955.84) (491,955.84)

0.00 0.00 CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 1,702.00 1,702.00 CWKS Diversion Asst JUN-16 MO (562.00) 0.00 (562.00)CWKs ARC (MOE) JUN-16 MO 16,427.00 1,201.00 17,628.00

0.00 0.00 ARC Exp. JUN-16 MO (24,885.00) (24,885.00)EBT FS GA/GR APR-16 MO (9,121.60) (9,121.60)

0.00 0.00 Total Miscellaneous Adjustment 15,865.00 (4,173,554.84) (4,157,689.84)

TOTAL 1,069,163.00 110,486.16 1,179,649.16 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: AlamedaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 166,800.00 166,800.00 KinGAP Asst SEP-16 MO 60,700.00 60,700.00

Total Advances 166,800.00 60,700.00 227,500.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 181,895.00 181,895.00 KinGAP Asst JUN-16 MO 67,747.00 67,747.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (160,000.00) (160,000.00)KinGAP Asst JUN-16 MO (56,800.00) (56,800.00)Net AdjustmentsFedGAP Asst JUN-16 MO 21,895.00 21,895.00 KinGAP Asst JUN-16 MO 10,947.00 10,947.00 Total Net Adjustments 21,895.00 10,947.00 32,842.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 21,895.00 10,947.00 32,842.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 15,955.00 4,963.00 20,918.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 15,955.00 4,963.00 20,918.00

TOTAL 204,650.00 76,610.00 281,260.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 204,650.00 204,650.00 CALWORKS Asst 1,069,725.00 (1,605,867.24) (536,142.24)CWKS Safety Net Asst 1,258,487.00 1,258,487.00 CWKS TANF Timed-Out Asst 318,427.00 318,427.00 CWKS Diversion Asst (562.00) 0.00 (562.00)KinGAP Asst 76,610.00 76,610.00 CWKS Recent Non-Citizens Mixed Cases 120,643.00 120,643.00 CWKS Recent Non-Citizens TANF Timed-Out 1,702.00 1,702.00 CWKS Recent Non-Citizens NonFederal 51,101.00 51,101.00 EBT FS GA/GR (9,121.60) (9,121.60)

0.00 0.00 ARC (24,885.00) (24,885.00)

0.00 0.00 TOTAL REMITTANCE 1,273,813.00 187,096.16 1,460,909.16 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: AlpineSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 28.00 350.00 378.00 CWKS Safety Net Asst SEP-16 MO 400.00 400.00 CWKS TANF Timed-Out Asst 0.00 0.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 28.00 750.00 778.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 51.00 402.00 453.00 CWKS Safety Net Asst JUN-16 MO 438.00 438.00 CWKS TANF Timed-Out Asst 0.00 0.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (136.00) (402.00) (538.00)CWKS Safety Net Asst JUN-16 MO (800.00) (800.00)CWKS TANF Timed-Out Asst 0.00 0.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO (85.00) 0.00 (85.00)CWKS Safety Net Asst JUN-16 MO (362.00) (362.00)CWKS TANF Timed-Out Asst 0.00 0.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments (85.00) (362.00) (447.00)

Calworks - Deferred Recoupment JUN-16 MO 57.00 57.00 Total Prior Period Adjustment (28.00) (362.00) (390.00)MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. 0.00 0.00 CWKS Monthly MOE Subaccount Act. 0.00 0.00 CWKS Monthly MOE Subaccount Est. 0.00 0.00 Family Support Subaccount 0.00 0.00 Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth 0.00 0.00 Child Poverty Subaccount Expenditure JUN-16 MO 94.00 94.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (8.55) (8.55)0.00 0.00

Total Miscellaneous Adjustment 0.00 85.45 85.45

TOTAL 0.00 473.45 473.45 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: AlpineSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00

Total Advances 0.00 0.00 0.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00 Less: Advances 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00 Net AdjustmentsFedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00 Total Net Adjustments 0.00 0.00 0.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 0.00 0.00 0.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 0.00 0.00 0.00

AS SHOWN ON REMITTANCE ADVICES0.00 0.00

CALWORKS Asst 0.00 444.00 444.00 CWKS Safety Net Asst 38.00 38.00

0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

EBT FS GA/GR (8.55) (8.55)0.00 0.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 0.00 473.45 473.45 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: AmadorSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 20,955.00 56,534.00 77,489.00 CWKS Safety Net Asst SEP-16 MO 13,100.00 13,100.00 CWKS TANF Timed-Out Asst SEP-16 MO 10,900.00 10,900.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 20,955.00 80,534.00 101,489.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 24,279.00 65,125.00 89,404.00 CWKS Safety Net Asst JUN-16 MO 14,636.00 14,636.00 CWKS TANF Timed-Out Asst JUN-16 MO 12,153.00 12,153.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (22,093.00) (65,125.00) (87,218.00)CWKS Safety Net Asst JUN-16 MO (13,200.00) (13,200.00)CWKS TANF Timed-Out Asst JUN-16 MO (9,700.00) (9,700.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (100.00) (100.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 2,186.00 0.00 2,186.00 CWKS Safety Net Asst JUN-16 MO 1,436.00 1,436.00 CWKS TANF Timed-Out Asst JUN-16 MO 2,453.00 2,453.00 CWKS Recent Non-Citizens Mixed Cases (100.00) (100.00)CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 2,186.00 3,789.00 5,975.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 2,186.00 3,789.00 5,975.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (59,301.00) (59,301.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (49,305.72) (49,305.72)CWKS Monthly MOE Subaccount Est. JUN-16 MO 51,981.00 51,981.00 Family Support Subaccount JUL-16 MO (17,840.22) (17,840.22)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (8,804.16) (8,804.16)Child Poverty Subaccount Expenditure JUN-16 MO 12,829.00 12,829.00 Child Poverty Subaccount Recoup** JUN-16 MO (9,003.96) (9,003.96)Child Poverty Growth FY14-15** FY 2015-16 (3,825.04) (3,825.04)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 326.00 0.00 326.00 0.00 0.00

ARC Exp. JUN-16 MO 451.00 451.00 ARC Exp. Deferred*** JUN-16 MO (451.00) (451.00)EBT FS GA/GR APR-16 MO (167.04) (167.04)

0.00 0.00 Total Miscellaneous Adjustment 326.00 (83,437.14) (83,111.14)

TOTAL 23,467.00 885.86 24,352.86 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: AmadorSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 1,000.00 1,000.00 KinGAP Asst SEP-16 MO 4,000.00 4,000.00

Total Advances 1,000.00 4,000.00 5,000.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 1,062.00 1,062.00 KinGAP Asst JUN-16 MO 4,450.00 4,450.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (1,000.00) (1,000.00)KinGAP Asst JUN-16 MO (5,100.00) (5,100.00)Net AdjustmentsFedGAP Asst JUN-16 MO 62.00 62.00 KinGAP Asst JUN-16 MO (650.00) (650.00)Total Net Adjustments 62.00 (650.00) (588.00)Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 62.00 (650.00) (588.00)

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 1,062.00 3,350.00 4,412.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 1,062.00 1,062.00 CALWORKS Asst 23,467.00 (26,736.10) (3,269.10)CWKS Safety Net Asst 14,536.00 14,536.00 CWKS TANF Timed-Out Asst 13,353.00 13,353.00

0.00 0.00 0.00 KinGAP Asst 3,350.00 3,350.00 CWKS Recent Non-Citizens Mixed Cases (100.00) (100.00)CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00

0.00 0.00 EBT FS GA/GR (167.04) (167.04)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 24,529.00 4,235.86 28,764.86 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ButteSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 257,948.00 617,020.00 874,968.00 CWKS Safety Net Asst SEP-16 MO 183,200.00 183,200.00 CWKS TANF Timed-Out Asst SEP-16 MO 125,900.00 125,900.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 5,000.00 5,000.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 257,948.00 931,120.00 1,189,068.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 269,105.00 706,909.00 976,014.00 CWKS Safety Net Asst JUN-16 MO 204,267.00 204,267.00 CWKS TANF Timed-Out Asst JUN-16 MO 140,650.00 140,650.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 5,520.00 5,520.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (239,815.00) (706,909.00) (946,724.00)CWKS Safety Net Asst JUN-16 MO (182,200.00) (182,200.00)CWKS TANF Timed-Out Asst JUN-16 MO (118,900.00) (118,900.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (6,300.00) (6,300.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 29,290.00 0.00 29,290.00 CWKS Safety Net Asst JUN-16 MO 22,067.00 22,067.00 CWKS TANF Timed-Out Asst JUN-16 MO 21,750.00 21,750.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (780.00) (780.00)CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 29,290.00 43,037.00 72,327.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 29,290.00 43,037.00 72,327.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (644,787.00) (644,787.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (536,109.20) (536,109.20)CWKS Monthly MOE Subaccount Est. JUN-16 MO 565,203.00 565,203.00 Family Support Subaccount JUL-16 MO (193,979.67) (193,979.67)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (95,729.07) (95,729.07)Child Poverty Subaccount Expenditure JUN-16 MO 143,774.00 143,774.00 Child Poverty Subaccount Recoup** JUN-16 MO (97,901.36) (97,901.36)Child Poverty Growth FY14-15** FY 2015-16 (45,872.64) (45,872.64)

0.00 0.00 CWKS Diversion Asst JUN-16 MO 685.00 0.00 685.00 CWKs ARC (MOE) JUN-16 MO 4,169.00 0.00 4,169.00 CWKs ARC (NON-MOE) JUN-16 MO 317.00 317.00 ARC Exp. JUN-16 MO 7,691.00 7,691.00 ARC Exp. Deferred*** JUN-16 MO (7,691.00) (7,691.00)EBT FS GA/GR APR-16 MO (1,576.87) (1,576.87)

0.00 0.00 Total Miscellaneous Adjustment 4,854.00 (906,661.81) (901,807.81)

TOTAL 292,092.00 67,495.19 359,587.19 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ButteSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 14,600.00 14,600.00 KinGAP Asst SEP-16 MO 26,400.00 26,400.00

Total Advances 14,600.00 26,400.00 41,000.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 15,883.00 15,883.00 KinGAP Asst JUN-16 MO 29,535.00 29,535.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (14,000.00) (14,000.00)KinGAP Asst JUN-16 MO (27,000.00) (27,000.00)Net AdjustmentsFedGAP Asst JUN-16 MO 1,883.00 1,883.00 KinGAP Asst JUN-16 MO 2,535.00 2,535.00 Total Net Adjustments 1,883.00 2,535.00 4,418.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,883.00 2,535.00 4,418.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00

Fraud Recovery Incentive JUN-16 QTR 22,607.00 22,607.00 Total Miscellaneous Adjustment 22,607.00 0.00 22,607.00

TOTAL 39,090.00 28,935.00 68,025.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 16,483.00 16,483.00 CALWORKS Asst 291,407.00 (288,064.94) 3,342.06 CWKS Safety Net Asst 205,267.00 205,267.00 CWKS TANF Timed-Out Asst 147,650.00 147,650.00 CWKS Diversion Asst 685.00 0.00 685.00 KinGAP Asst 28,935.00 28,935.00 CWKS Recent Non-Citizens Mixed Cases 4,220.00 4,220.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00

0.00 0.00 EBT FS GA/GR (1,576.87) (1,576.87)Fraud Recovery Incentive 22,607.00 22,607.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 331,182.00 96,430.19 427,612.19 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: CalaverasSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 35,736.00 91,273.00 127,009.00 CWKS Safety Net Asst SEP-16 MO 27,000.00 27,000.00 CWKS TANF Timed-Out Asst SEP-16 MO 12,600.00 12,600.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 500.00 500.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 35,736.00 131,373.00 167,109.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 43,143.00 99,218.00 142,361.00 CWKS Safety Net Asst JUN-16 MO 30,083.00 30,083.00 CWKS TANF Timed-Out Asst JUN-16 MO 14,057.00 14,057.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 529.00 529.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (33,659.00) (99,218.00) (132,877.00)CWKS Safety Net Asst JUN-16 MO (24,100.00) (24,100.00)CWKS TANF Timed-Out Asst JUN-16 MO (11,500.00) (11,500.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (500.00) (500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 9,484.00 0.00 9,484.00 CWKS Safety Net Asst JUN-16 MO 5,983.00 5,983.00 CWKS TANF Timed-Out Asst JUN-16 MO 2,557.00 2,557.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 29.00 29.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 9,484.00 8,569.00 18,053.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 9,484.00 8,569.00 18,053.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (95,551.00) (95,551.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (79,445.67) (79,445.67)CWKS Monthly MOE Subaccount Est. JUN-16 MO 83,757.00 83,757.00 Family Support Subaccount JUL-16 MO (28,745.72) (28,745.72)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (14,186.03) (14,186.03)Child Poverty Subaccount Expenditure JUN-16 MO 19,820.00 19,820.00 Child Poverty Subaccount Recoup** JUN-16 MO (14,507.94) (14,507.94)Child Poverty Growth FY14-15** FY 2015-16 (5,312.06) (5,312.06)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (257.36) (257.36)0.00 0.00

Total Miscellaneous Adjustment 0.00 (134,428.78) (134,428.78)

TOTAL 45,220.00 5,513.22 50,733.22 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: CalaverasSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 3,300.00 3,300.00 KinGAP Asst SEP-16 MO 1,100.00 1,100.00

Total Advances 3,300.00 1,100.00 4,400.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 3,599.00 3,599.00 KinGAP Asst JUN-16 MO 1,203.00 1,203.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (3,300.00) (3,300.00)KinGAP Asst JUN-16 MO (600.00) (600.00)Net AdjustmentsFedGAP Asst JUN-16 MO 299.00 299.00 KinGAP Asst JUN-16 MO 603.00 603.00 Total Net Adjustments 299.00 603.00 902.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 299.00 603.00 902.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 679.00 679.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 679.00 679.00

TOTAL 3,599.00 2,382.00 5,981.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 3,599.00 3,599.00 CALWORKS Asst 45,220.00 (42,898.42) 2,321.58 CWKS Safety Net Asst 32,983.00 32,983.00 CWKS TANF Timed-Out Asst 15,157.00 15,157.00

0.00 0.00 0.00 KinGAP Asst 2,382.00 2,382.00 CWKS Recent Non-Citizens Mixed Cases 529.00 529.00

0.00 0.00 0.00 0.00

EBT FS GA/GR (257.36) (257.36)0.00 0.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 48,819.00 7,895.22 56,714.22 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ColusaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 7,827.00 33,493.00 41,320.00 CWKS Safety Net Asst SEP-16 MO 10,800.00 10,800.00 CWKS TANF Timed-Out Asst SEP-16 MO 3,800.00 3,800.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 1,000.00 1,000.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 7,827.00 49,093.00 56,920.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 9,332.00 37,335.00 46,667.00 CWKS Safety Net Asst JUN-16 MO 12,050.00 12,050.00 CWKS TANF Timed-Out Asst JUN-16 MO 4,278.00 4,278.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,062.00 1,062.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (12,666.00) (37,335.00) (50,001.00)CWKS Safety Net Asst JUN-16 MO (11,700.00) (11,700.00)CWKS TANF Timed-Out Asst JUN-16 MO (1,500.00) (1,500.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,000.00) (1,000.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO (3,334.00) 0.00 (3,334.00)CWKS Safety Net Asst JUN-16 MO 350.00 350.00 CWKS TANF Timed-Out Asst JUN-16 MO 2,778.00 2,778.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 62.00 62.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments (3,334.00) 3,190.00 (144.00)

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment (3,334.00) 3,190.00 (144.00)MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. 0.00 0.00 CWKS Monthly MOE Subaccount Act. 0.00 0.00 CWKS Monthly MOE Subaccount Est. 0.00 0.00 Family Support Subaccount 0.00 0.00 Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth 0.00 0.00 Child Poverty Subaccount Expenditure JUN-16 MO 6,827.00 6,827.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 867.00 0.00 867.00

0.00 0.00 ARC Exp. JUN-16 MO 738.00 738.00 EBT FS GA/GR APR-16 MO (58.11) (58.11)

0.00 0.00 Total Miscellaneous Adjustment 867.00 7,506.89 8,373.89

TOTAL 5,360.00 59,789.89 65,149.89 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ColusaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 1,100.00 1,100.00 KinGAP Asst 0.00 0.00

Total Advances 1,100.00 0.00 1,100.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 1,173.00 1,173.00 KinGAP Asst 0.00 0.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (1,800.00) (1,800.00)KinGAP Asst 0.00 0.00 Net AdjustmentsFedGAP Asst JUN-16 MO (627.00) (627.00)KinGAP Asst 0.00 0.00 Total Net Adjustments (627.00) 0.00 (627.00)Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment (627.00) 0.00 (627.00)

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 473.00 0.00 473.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 473.00 473.00 CALWORKS Asst 5,360.00 40,320.00 45,680.00 CWKS Safety Net Asst 11,150.00 11,150.00 CWKS TANF Timed-Out Asst 6,578.00 6,578.00

0.00 0.00 0.00 0.00 0.00

CWKS Recent Non-Citizens Mixed Cases 1,062.00 1,062.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00

0.00 0.00 EBT FS GA/GR (58.11) (58.11)

0.00 0.00 ARC 738.00 738.00

0.00 0.00 TOTAL REMITTANCE 5,833.00 59,789.89 65,622.89 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Contra CostaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 668,164.00 1,566,167.00 2,234,331.00 CWKS Safety Net Asst SEP-16 MO 602,000.00 602,000.00 CWKS TANF Timed-Out Asst SEP-16 MO 262,800.00 262,800.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 39,200.00 39,200.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 24,900.00 24,900.00 Total Advances 668,164.00 2,495,067.00 3,163,231.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 748,523.00 1,755,112.00 2,503,635.00 CWKS Safety Net Asst JUN-16 MO 669,791.00 669,791.00 CWKS TANF Timed-Out Asst JUN-16 MO 293,690.00 293,690.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 43,672.00 43,672.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 27,656.00 27,656.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (595,412.00) (1,755,112.00) (2,350,524.00)CWKS Safety Net Asst JUN-16 MO (621,600.00) (621,600.00)CWKS TANF Timed-Out Asst JUN-16 MO (252,100.00) (252,100.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (36,200.00) (36,200.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (26,700.00) (26,700.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 153,111.00 0.00 153,111.00 CWKS Safety Net Asst JUN-16 MO 48,191.00 48,191.00 CWKS TANF Timed-Out Asst JUN-16 MO 41,590.00 41,590.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 7,472.00 7,472.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 956.00 956.00 Total Net Adjustments 153,111.00 98,209.00 251,320.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 153,111.00 98,209.00 251,320.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (1,841,259.00) (1,841,259.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (1,530,918.18) (1,530,918.18)CWKS Monthly MOE Subaccount Est. JUN-16 MO 1,613,999.00 1,613,999.00 Family Support Subaccount JUL-16 MO (553,930.05) (553,930.05)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (273,364.77) (273,364.77)Child Poverty Subaccount Expenditure JUN-16 MO 383,471.00 383,471.00 Child Poverty Subaccount Recoup** JUN-16 MO (279,568.04) (279,568.04)Child Poverty Growth FY14-15** FY 2015-16 (103,902.96) (103,902.96)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 1,779.00 1,779.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 19,431.00 0.00 19,431.00

0.00 0.00 ARC Exp. JUN-16 MO 20,837.00 20,837.00 EBT FS GA/GR APR-16 MO (3,827.95) (3,827.95)

0.00 0.00 Total Miscellaneous Adjustment 19,431.00 (2,566,684.95) (2,547,253.95)

TOTAL 840,706.00 26,591.05 867,297.05 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Contra CostaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 78,900.00 78,900.00 KinGAP Asst SEP-16 MO 41,200.00 41,200.00

Total Advances 78,900.00 41,200.00 120,100.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 86,092.00 86,092.00 KinGAP Asst JUN-16 MO 46,046.00 46,046.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (77,000.00) (77,000.00)KinGAP Asst JUN-16 MO (37,700.00) (37,700.00)Net AdjustmentsFedGAP Asst JUN-16 MO 9,092.00 9,092.00 KinGAP Asst JUN-16 MO 8,346.00 8,346.00 Total Net Adjustments 9,092.00 8,346.00 17,438.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 9,092.00 8,346.00 17,438.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 2,318.00 1,326.00 3,644.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 2,318.00 1,326.00 3,644.00

TOTAL 90,310.00 50,872.00 141,182.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 90,310.00 90,310.00 CALWORKS Asst 840,706.00 (1,019,306.00) (178,600.00)CWKS Safety Net Asst 650,191.00 650,191.00 CWKS TANF Timed-Out Asst 304,390.00 304,390.00

0.00 0.00 0.00 KinGAP Asst 50,872.00 50,872.00 CWKS Recent Non-Citizens Mixed Cases 46,672.00 46,672.00 CWKS Recent Non-Citizens TANF Timed-Out 1,779.00 1,779.00 CWKS Recent Non-Citizens NonFederal 25,856.00 25,856.00 EBT FS GA/GR (3,827.95) (3,827.95)

0.00 0.00 ARC 20,837.00 20,837.00

0.00 0.00 TOTAL REMITTANCE 931,016.00 77,463.05 1,008,479.05 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Del NorteSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 71,277.00 148,746.00 220,023.00 CWKS Safety Net Asst SEP-16 MO 53,100.00 53,100.00 CWKS TANF Timed-Out Asst SEP-16 MO 25,000.00 25,000.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 300.00 300.00 Total Advances 71,277.00 227,146.00 298,423.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 64,306.00 172,552.00 236,858.00 CWKS Safety Net Asst JUN-16 MO 59,208.00 59,208.00 CWKS TANF Timed-Out Asst JUN-16 MO 27,910.00 27,910.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 318.00 318.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (58,537.00) (172,552.00) (231,089.00)CWKS Safety Net Asst JUN-16 MO (46,800.00) (46,800.00)CWKS TANF Timed-Out Asst JUN-16 MO (22,000.00) (22,000.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO (300.00) (300.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 5,769.00 0.00 5,769.00 CWKS Safety Net Asst JUN-16 MO 12,408.00 12,408.00 CWKS TANF Timed-Out Asst JUN-16 MO 5,910.00 5,910.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 18.00 18.00 Total Net Adjustments 5,769.00 18,336.00 24,105.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 5,769.00 18,336.00 24,105.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (136,193.00) (136,193.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (113,238.30) (113,238.30)CWKS Monthly MOE Subaccount Est. JUN-16 MO 119,384.00 119,384.00 Family Support Subaccount JUL-16 MO (40,972.86) (40,972.86)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (20,220.13) (20,220.13)Child Poverty Subaccount Expenditure JUN-16 MO 34,801.00 34,801.00 Child Poverty Subaccount Recoup** JUN-16 MO (20,678.96) (20,678.96)

0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (242.75) (242.75)0.00 0.00

Total Miscellaneous Adjustment 0.00 (177,361.00) (177,361.00)

TOTAL 77,046.00 68,121.00 145,167.00 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Del NorteSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 300.00 300.00 KinGAP Asst SEP-16 MO 4,900.00 4,900.00

Total Advances 300.00 4,900.00 5,200.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 372.00 372.00 KinGAP Asst JUN-16 MO 5,421.00 5,421.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (300.00) (300.00)KinGAP Asst JUN-16 MO (4,900.00) (4,900.00)Net AdjustmentsFedGAP Asst JUN-16 MO 72.00 72.00 KinGAP Asst JUN-16 MO 521.00 521.00 Total Net Adjustments 72.00 521.00 593.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 72.00 521.00 593.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 372.00 5,421.00 5,793.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 372.00 372.00 CALWORKS Asst 77,046.00 (28,372.25) 48,673.75 CWKS Safety Net Asst 65,508.00 65,508.00 CWKS TANF Timed-Out Asst 30,910.00 30,910.00

0.00 0.00 0.00 KinGAP Asst 5,421.00 5,421.00

0.00 0.00 0.00 0.00

CWKS Recent Non-Citizens NonFederal 318.00 318.00 EBT FS GA/GR (242.75) (242.75)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 77,418.00 73,542.00 150,960.00 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: El DoradoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 99,603.00 207,386.00 306,989.00 CWKS Safety Net Asst SEP-16 MO 51,200.00 51,200.00 CWKS TANF Timed-Out Asst SEP-16 MO 11,800.00 11,800.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 1,100.00 1,100.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 99,603.00 271,486.00 371,089.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 110,824.00 235,771.00 346,595.00 CWKS Safety Net Asst JUN-16 MO 57,095.00 57,095.00 CWKS TANF Timed-Out Asst JUN-16 MO 13,233.00 13,233.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 2,541.00 2,541.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (79,984.00) (235,771.00) (315,755.00)CWKS Safety Net Asst JUN-16 MO (49,300.00) (49,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (11,300.00) (11,300.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,200.00) (1,200.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 30,840.00 0.00 30,840.00 CWKS Safety Net Asst JUN-16 MO 7,795.00 7,795.00 CWKS TANF Timed-Out Asst JUN-16 MO 1,933.00 1,933.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,341.00 1,341.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 30,840.00 11,069.00 41,909.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 30,840.00 11,069.00 41,909.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (180,590.00) (180,590.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (150,151.86) (150,151.86)CWKS Monthly MOE Subaccount Est. JUN-16 MO 158,300.00 158,300.00 Family Support Subaccount JUL-16 MO (54,329.24) (54,329.24)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (26,811.51) (26,811.51)Child Poverty Subaccount Expenditure JUN-16 MO 45,478.00 45,478.00 Child Poverty Subaccount Recoup** JUN-16 MO (27,419.94) (27,419.94)

0.00 0.00 CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 466.00 466.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 8,051.00 0.00 8,051.00

0.00 0.00 ARC Exp. JUN-16 MO 8,989.00 8,989.00 EBT FS GA/GR APR-16 MO (669.41) (669.41)

0.00 0.00 Total Miscellaneous Adjustment 8,051.00 (226,738.96) (218,687.96)

TOTAL 138,494.00 55,816.04 194,310.04 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: El DoradoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 6,400.00 6,400.00 KinGAP Asst SEP-16 MO 3,300.00 3,300.00

Total Advances 6,400.00 3,300.00 9,700.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 7,946.00 7,946.00 KinGAP Asst JUN-16 MO 3,679.00 3,679.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (4,400.00) (4,400.00)KinGAP Asst JUN-16 MO (2,700.00) (2,700.00)Net AdjustmentsFedGAP Asst JUN-16 MO 3,546.00 3,546.00 KinGAP Asst JUN-16 MO 979.00 979.00 Total Net Adjustments 3,546.00 979.00 4,525.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 3,546.00 979.00 4,525.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 9,946.00 4,279.00 14,225.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 9,946.00 9,946.00 CALWORKS Asst 138,494.00 (28,138.55) 110,355.45 CWKS Safety Net Asst 58,995.00 58,995.00 CWKS TANF Timed-Out Asst 13,733.00 13,733.00

0.00 0.00 0.00 KinGAP Asst 4,279.00 4,279.00 CWKS Recent Non-Citizens Mixed Cases 2,441.00 2,441.00 CWKS Recent Non-Citizens TANF Timed-Out 466.00 466.00

0.00 0.00 EBT FS GA/GR (669.41) (669.41)

0.00 0.00 ARC 8,989.00 8,989.00

0.00 0.00 TOTAL REMITTANCE 148,440.00 60,095.04 208,535.04 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: FresnoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 2,267,373.00 4,707,377.00 6,974,750.00 CWKS Safety Net Asst SEP-16 MO 2,080,600.00 2,080,600.00 CWKS TANF Timed-Out Asst SEP-16 MO 720,700.00 720,700.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 86,200.00 86,200.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 15,500.00 15,500.00 Total Advances 2,267,373.00 7,610,377.00 9,877,750.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 2,327,336.00 5,476,282.00 7,803,618.00 CWKS Safety Net Asst JUN-16 MO 2,319,058.00 2,319,058.00 CWKS TANF Timed-Out Asst JUN-16 MO 805,298.00 805,298.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 96,100.00 96,100.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 17,261.00 17,261.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (1,857,798.00) (5,476,282.00) (7,334,080.00)CWKS Safety Net Asst JUN-16 MO (2,124,300.00) (2,124,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (714,400.00) (714,400.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (84,500.00) (84,500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (15,900.00) (15,900.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 469,538.00 0.00 469,538.00 CWKS Safety Net Asst JUN-16 MO 194,758.00 194,758.00 CWKS TANF Timed-Out Asst JUN-16 MO 90,898.00 90,898.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 11,600.00 11,600.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 1,361.00 1,361.00 Total Net Adjustments 469,538.00 298,617.00 768,155.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 469,538.00 298,617.00 768,155.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (5,174,111.00) (5,174,111.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (4,302,023.96) (4,302,023.96)CWKS Monthly MOE Subaccount Est. JUN-16 MO 4,535,489.00 4,535,489.00 Family Support Subaccount JUL-16 MO (1,556,595.51) (1,556,595.51)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (768,180.69) (768,180.69)Child Poverty Subaccount Expenditure JUN-16 MO 1,199,982.00 1,199,982.00 Child Poverty Subaccount Recoup** JUN-16 MO (785,612.44) (785,612.44)Child Poverty Growth FY14-15** FY 2015-16 (414,369.56) (414,369.56)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 2,084.00 2,084.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 23,508.00 0.00 23,508.00

0.00 0.00 ARC Exp. JUN-16 MO 28,755.00 28,755.00 EBT FS GA/GR APR-16 MO (11,124.68) (11,124.68)

0.00 0.00 Total Miscellaneous Adjustment 23,508.00 (7,245,707.84) (7,222,199.84)

TOTAL 2,760,419.00 663,286.16 3,423,705.16 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: FresnoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 61,300.00 61,300.00 KinGAP Asst SEP-16 MO 183,900.00 183,900.00

Total Advances 61,300.00 183,900.00 245,200.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 66,885.00 66,885.00 KinGAP Asst JUN-16 MO 205,344.00 205,344.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (60,500.00) (60,500.00)KinGAP Asst JUN-16 MO (178,000.00) (178,000.00)Net AdjustmentsFedGAP Asst JUN-16 MO 6,385.00 6,385.00 KinGAP Asst JUN-16 MO 27,344.00 27,344.00 Total Net Adjustments 6,385.00 27,344.00 33,729.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 6,385.00 27,344.00 33,729.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 787.00 2,185.00 2,972.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 787.00 2,185.00 2,972.00

TOTAL 68,472.00 213,429.00 281,901.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 68,472.00 68,472.00 CALWORKS Asst 2,760,419.00 (2,558,045.16) 202,373.84 CWKS Safety Net Asst 2,275,358.00 2,275,358.00 CWKS TANF Timed-Out Asst 811,598.00 811,598.00

0.00 0.00 0.00 KinGAP Asst 213,429.00 213,429.00 CWKS Recent Non-Citizens Mixed Cases 97,800.00 97,800.00 CWKS Recent Non-Citizens TANF Timed-Out 2,084.00 2,084.00 CWKS Recent Non-Citizens NonFederal 16,861.00 16,861.00 EBT FS GA/GR (11,124.68) (11,124.68)

0.00 0.00 ARC 28,755.00 28,755.00

0.00 0.00 TOTAL REMITTANCE 2,828,891.00 876,715.16 3,705,606.16 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: GlennSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 44,461.00 78,890.00 123,351.00 CWKS Safety Net Asst SEP-16 MO 15,800.00 15,800.00 CWKS TANF Timed-Out Asst SEP-16 MO 9,200.00 9,200.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 600.00 600.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 44,461.00 104,490.00 148,951.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 47,764.00 90,767.00 138,531.00 CWKS Safety Net Asst JUN-16 MO 17,634.00 17,634.00 CWKS TANF Timed-Out Asst JUN-16 MO 10,279.00 10,279.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,171.00 1,171.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (30,792.00) (90,767.00) (121,559.00)CWKS Safety Net Asst JUN-16 MO (15,600.00) (15,600.00)CWKS TANF Timed-Out Asst JUN-16 MO (9,700.00) (9,700.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (400.00) (400.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 16,972.00 0.00 16,972.00 CWKS Safety Net Asst JUN-16 MO 2,034.00 2,034.00 CWKS TANF Timed-Out Asst JUN-16 MO 579.00 579.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 771.00 771.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 16,972.00 3,384.00 20,356.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 16,972.00 3,384.00 20,356.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (74,037.00) (74,037.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (61,557.95) (61,557.95)CWKS Monthly MOE Subaccount Est. JUN-16 MO 64,899.00 64,899.00 Family Support Subaccount JUL-16 MO (22,273.43) (22,273.43)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (10,991.95) (10,991.95)Child Poverty Subaccount Expenditure JUN-16 MO 18,007.00 18,007.00 Child Poverty Subaccount Recoup** JUN-16 MO (11,241.39) (11,241.39)Child Poverty Growth FY14-15** FY 2015-16 (6,765.61) (6,765.61)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 652.00 0.00 652.00 0.00 0.00

ARC Exp. JUN-16 MO 809.00 809.00 EBT FS GA/GR APR-16 MO (145.68) (145.68)

0.00 0.00 Total Miscellaneous Adjustment 652.00 (103,298.01) (102,646.01)

TOTAL 62,085.00 4,575.99 66,660.99 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: GlennSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 2,500.00 2,500.00 KinGAP Asst SEP-16 MO 2,200.00 2,200.00

Total Advances 2,500.00 2,200.00 4,700.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 2,760.00 2,760.00 KinGAP Asst JUN-16 MO 2,411.00 2,411.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (2,500.00) (2,500.00)KinGAP Asst JUN-16 MO (2,200.00) (2,200.00)Net AdjustmentsFedGAP Asst JUN-16 MO 260.00 260.00 KinGAP Asst JUN-16 MO 211.00 211.00 Total Net Adjustments 260.00 211.00 471.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 260.00 211.00 471.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 2,760.00 2,411.00 5,171.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 2,760.00 2,760.00 CALWORKS Asst 62,085.00 (25,071.33) 37,013.67 CWKS Safety Net Asst 17,834.00 17,834.00 CWKS TANF Timed-Out Asst 9,779.00 9,779.00

0.00 0.00 0.00 KinGAP Asst 2,411.00 2,411.00 CWKS Recent Non-Citizens Mixed Cases 1,371.00 1,371.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00

0.00 0.00 EBT FS GA/GR (145.68) (145.68)

0.00 0.00 ARC 809.00 809.00

0.00 0.00 TOTAL REMITTANCE 64,845.00 6,986.99 71,831.99 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: HumboldtSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 180,755.00 329,818.00 510,573.00 CWKS Safety Net Asst SEP-16 MO 89,900.00 89,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 37,500.00 37,500.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 180,755.00 457,218.00 637,973.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 196,185.00 375,840.00 572,025.00 CWKS Safety Net Asst JUN-16 MO 100,252.00 100,252.00 CWKS TANF Timed-Out Asst JUN-16 MO 41,860.00 41,860.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (30.00) (30.00)CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (127,502.00) (375,840.00) (503,342.00)CWKS Safety Net Asst JUN-16 MO (90,800.00) (90,800.00)CWKS TANF Timed-Out Asst JUN-16 MO (35,600.00) (35,600.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 68,683.00 0.00 68,683.00 CWKS Safety Net Asst JUN-16 MO 9,452.00 9,452.00 CWKS TANF Timed-Out Asst JUN-16 MO 6,260.00 6,260.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (30.00) (30.00)CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 68,683.00 15,682.00 84,365.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 68,683.00 15,682.00 84,365.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (303,915.00) (303,915.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (252,690.77) (252,690.77)CWKS Monthly MOE Subaccount Est. JUN-16 MO 266,404.00 266,404.00 Family Support Subaccount JUL-16 MO (91,430.76) (91,430.76)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (45,121.13) (45,121.13)Child Poverty Subaccount Expenditure JUN-16 MO 77,535.00 77,535.00 Child Poverty Subaccount Recoup** JUN-16 MO (46,145.02) (46,145.02)

0.00 0.00 0.00 0.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 3,887.00 0.00 3,887.00

0.00 0.00 ARC Exp. JUN-16 MO 4,081.00 4,081.00 EBT FS GA/GR APR-16 MO (1,164.95) (1,164.95)

0.00 0.00 Total Miscellaneous Adjustment 3,887.00 (392,447.63) (388,560.63)

TOTAL 253,325.00 80,452.37 333,777.37 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: HumboldtSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 13,000.00 13,000.00 KinGAP Asst SEP-16 MO 14,100.00 14,100.00

Total Advances 13,000.00 14,100.00 27,100.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 14,160.00 14,160.00 KinGAP Asst JUN-16 MO 15,767.00 15,767.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (13,100.00) (13,100.00)KinGAP Asst JUN-16 MO (10,800.00) (10,800.00)Net AdjustmentsFedGAP Asst JUN-16 MO 1,060.00 1,060.00 KinGAP Asst JUN-16 MO 4,967.00 4,967.00 Total Net Adjustments 1,060.00 4,967.00 6,027.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,060.00 4,967.00 6,027.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 14,060.00 19,067.00 33,127.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 14,060.00 14,060.00 CALWORKS Asst 253,325.00 (65,545.68) 187,779.32 CWKS Safety Net Asst 99,352.00 99,352.00 CWKS TANF Timed-Out Asst 43,760.00 43,760.00

0.00 0.00 0.00 KinGAP Asst 19,067.00 19,067.00 CWKS Recent Non-Citizens Mixed Cases (30.00) (30.00)CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00

0.00 0.00 EBT FS GA/GR (1,164.95) (1,164.95)

0.00 0.00 ARC 4,081.00 4,081.00

0.00 0.00 TOTAL REMITTANCE 267,385.00 99,519.37 366,904.37 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ImperialSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 501,828.00 821,938.00 1,323,766.00 CWKS Safety Net Asst SEP-16 MO 405,600.00 405,600.00 CWKS TANF Timed-Out Asst SEP-16 MO 127,900.00 127,900.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 18,400.00 18,400.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 2,800.00 2,800.00 Total Advances 501,828.00 1,376,638.00 1,878,466.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 494,803.00 972,959.00 1,467,762.00 CWKS Safety Net Asst JUN-16 MO 451,397.00 451,397.00 CWKS TANF Timed-Out Asst JUN-16 MO 142,957.00 142,957.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 20,500.00 20,500.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 3,688.00 3,688.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (330,071.00) (972,959.00) (1,303,030.00)CWKS Safety Net Asst JUN-16 MO (407,500.00) (407,500.00)CWKS TANF Timed-Out Asst JUN-16 MO (119,400.00) (119,400.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (17,500.00) (17,500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (2,500.00) (2,500.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 164,732.00 0.00 164,732.00 CWKS Safety Net Asst JUN-16 MO 43,897.00 43,897.00 CWKS TANF Timed-Out Asst JUN-16 MO 23,557.00 23,557.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 3,000.00 3,000.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 1,188.00 1,188.00 Total Net Adjustments 164,732.00 71,642.00 236,374.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 164,732.00 71,642.00 236,374.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (832,365.00) (832,365.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (692,071.27) (692,071.27)CWKS Monthly MOE Subaccount Est. JUN-16 MO 729,629.00 729,629.00 Family Support Subaccount JUL-16 MO (250,411.21) (250,411.21)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (123,578.06) (123,578.06)Child Poverty Subaccount Expenditure JUN-16 MO 221,842.00 221,842.00 Child Poverty Subaccount Recoup** JUN-16 MO (126,382.33) (126,382.33)

0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (1,582.28) (1,582.28)0.00 0.00

Total Miscellaneous Adjustment 0.00 (1,074,919.15) (1,074,919.15)

TOTAL 666,560.00 373,360.85 1,039,920.85 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ImperialSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 18,500.00 18,500.00 KinGAP Asst SEP-16 MO 17,000.00 17,000.00

Total Advances 18,500.00 17,000.00 35,500.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 20,201.00 20,201.00 KinGAP Asst JUN-16 MO 18,949.00 18,949.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (15,100.00) (15,100.00)KinGAP Asst JUN-16 MO (17,800.00) (17,800.00)Net AdjustmentsFedGAP Asst JUN-16 MO 5,101.00 5,101.00 KinGAP Asst JUN-16 MO 1,149.00 1,149.00 Total Net Adjustments 5,101.00 1,149.00 6,250.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 5,101.00 1,149.00 6,250.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 23,601.00 18,149.00 41,750.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 23,601.00 23,601.00 CALWORKS Asst 666,560.00 (251,398.87) 415,161.13 CWKS Safety Net Asst 449,497.00 449,497.00 CWKS TANF Timed-Out Asst 151,457.00 151,457.00

0.00 0.00 0.00 KinGAP Asst 18,149.00 18,149.00 CWKS Recent Non-Citizens Mixed Cases 21,400.00 21,400.00

0.00 0.00 CWKS Recent Non-Citizens NonFederal 3,988.00 3,988.00 EBT FS GA/GR (1,582.28) (1,582.28)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 690,161.00 391,509.85 1,081,670.85 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: InyoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 9,242.00 22,068.00 31,310.00 CWKS Safety Net Asst SEP-16 MO 8,900.00 8,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 1,600.00 1,600.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 500.00 500.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 9,242.00 33,068.00 42,310.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 12,645.00 24,816.00 37,461.00 CWKS Safety Net Asst JUN-16 MO 9,906.00 9,906.00 CWKS TANF Timed-Out Asst JUN-16 MO 2,256.00 2,256.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 577.00 577.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (8,419.00) (24,816.00) (33,235.00)CWKS Safety Net Asst JUN-16 MO (9,000.00) (9,000.00)CWKS TANF Timed-Out Asst JUN-16 MO (900.00) (900.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (500.00) (500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 4,226.00 0.00 4,226.00 CWKS Safety Net Asst JUN-16 MO 906.00 906.00 CWKS TANF Timed-Out Asst JUN-16 MO 1,356.00 1,356.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 77.00 77.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 4,226.00 2,339.00 6,565.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 4,226.00 2,339.00 6,565.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. 0.00 0.00 CWKS Monthly MOE Subaccount Act. 0.00 0.00 CWKS Monthly MOE Subaccount Est. 0.00 0.00 Family Support Subaccount 0.00 0.00 Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth 0.00 0.00 Child Poverty Subaccount Expenditure JUN-16 MO 5,359.00 5,359.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (98.34) (98.34)0.00 0.00

Total Miscellaneous Adjustment 0.00 5,260.66 5,260.66

TOTAL 13,468.00 40,667.66 54,135.66 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: InyoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 2,700.00 2,700.00 KinGAP Asst SEP-16 MO 600.00 600.00

Total Advances 2,700.00 600.00 3,300.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 2,947.00 2,947.00 KinGAP Asst JUN-16 MO 616.00 616.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (3,000.00) (3,000.00)KinGAP Asst 0.00 0.00 Net AdjustmentsFedGAP Asst JUN-16 MO (53.00) (53.00)KinGAP Asst JUN-16 MO 616.00 616.00 Total Net Adjustments (53.00) 616.00 563.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment (53.00) 616.00 563.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

KinGAP 18 Plus DEC-13 MO (600.00) (600.00)0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 (600.00) (600.00)

TOTAL 2,647.00 616.00 3,263.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 2,647.00 2,647.00 CALWORKS Asst 13,468.00 27,427.00 40,895.00 CWKS Safety Net Asst 9,806.00 9,806.00 CWKS TANF Timed-Out Asst 2,956.00 2,956.00

0.00 0.00 0.00 KinGAP Asst 616.00 616.00 CWKS Recent Non-Citizens Mixed Cases 577.00 577.00

0.00 0.00 0.00 0.00

EBT FS GA/GR (98.34) (98.34)0.00 0.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 16,115.00 41,283.66 57,398.66 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: KernSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 2,016,541.00 3,632,175.00 5,648,716.00 CWKS Safety Net Asst SEP-16 MO 1,220,700.00 1,220,700.00 CWKS TANF Timed-Out Asst SEP-16 MO 517,900.00 517,900.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 41,500.00 41,500.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 5,000.00 5,000.00 Total Advances 2,016,541.00 5,417,275.00 7,433,816.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 1,934,401.00 4,300,760.00 6,235,161.00 CWKS Safety Net Asst JUN-16 MO 1,360,610.00 1,360,610.00 CWKS TANF Timed-Out Asst JUN-16 MO 578,709.00 578,709.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 46,298.00 46,298.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 5,561.00 5,561.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (1,459,009.00) (4,300,760.00) (5,759,769.00)CWKS Safety Net Asst JUN-16 MO (1,229,200.00) (1,229,200.00)CWKS TANF Timed-Out Asst JUN-16 MO (507,700.00) (507,700.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (47,900.00) (47,900.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (7,000.00) (7,000.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 475,392.00 0.00 475,392.00 CWKS Safety Net Asst JUN-16 MO 131,410.00 131,410.00 CWKS TANF Timed-Out Asst JUN-16 MO 71,009.00 71,009.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,602.00) (1,602.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (1,439.00) (1,439.00)Total Net Adjustments 475,392.00 199,378.00 674,770.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 475,392.00 199,378.00 674,770.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (3,628,704.00) (3,628,704.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (3,017,092.47) (3,017,092.47)CWKS Monthly MOE Subaccount Est. JUN-16 MO 3,180,826.00 3,180,826.00 Family Support Subaccount JUL-16 MO (1,091,670.49) (1,091,670.49)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (538,739.95) (538,739.95)Child Poverty Subaccount Expenditure JUN-16 MO 880,727.00 880,727.00 Child Poverty Subaccount Recoup** JUN-16 MO (550,965.17) (550,965.17)Child Poverty Growth FY14-15** FY 2015-16 (51,919.87) (51,919.87)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 46,356.00 0.00 46,356.00 0.00 0.00

ARC Exp. JUN-16 MO 59,636.00 59,636.00 EBT FS GA/GR APR-16 MO (6,517.76) (6,517.76)

0.00 0.00 Total Miscellaneous Adjustment 46,356.00 (4,764,420.71) (4,718,064.71)

TOTAL 2,538,289.00 852,232.29 3,390,521.29 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: KernSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 128,800.00 128,800.00 KinGAP Asst SEP-16 MO 74,600.00 74,600.00

Total Advances 128,800.00 74,600.00 203,400.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 140,458.00 140,458.00 KinGAP Asst JUN-16 MO 83,321.00 83,321.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (123,500.00) (123,500.00)KinGAP Asst JUN-16 MO (76,900.00) (76,900.00)Net AdjustmentsFedGAP Asst JUN-16 MO 16,958.00 16,958.00 KinGAP Asst JUN-16 MO 6,421.00 6,421.00 Total Net Adjustments 16,958.00 6,421.00 23,379.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 16,958.00 6,421.00 23,379.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 682.00 1,917.00 2,599.00 KinGAP 18 Plus DEC-13 MO 600.00 600.00

0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 682.00 2,517.00 3,199.00

TOTAL 146,440.00 83,538.00 229,978.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 146,440.00 146,440.00 CALWORKS Asst 2,538,289.00 (1,185,363.95) 1,352,925.05 CWKS Safety Net Asst 1,352,110.00 1,352,110.00 CWKS TANF Timed-Out Asst 588,909.00 588,909.00

0.00 0.00 0.00 KinGAP Asst 83,538.00 83,538.00 CWKS Recent Non-Citizens Mixed Cases 39,898.00 39,898.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 3,561.00 3,561.00 EBT FS GA/GR (6,517.76) (6,517.76)

0.00 0.00 ARC 59,636.00 59,636.00

0.00 0.00 TOTAL REMITTANCE 2,684,729.00 935,770.29 3,620,499.29 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: KingsSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 183,477.00 554,761.00 738,238.00 CWKS Safety Net Asst SEP-16 MO 148,500.00 148,500.00 CWKS TANF Timed-Out Asst SEP-16 MO 58,200.00 58,200.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 10,400.00 10,400.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 200.00 200.00 Total Advances 183,477.00 772,061.00 955,538.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 222,832.00 643,910.00 866,742.00 CWKS Safety Net Asst JUN-16 MO 165,460.00 165,460.00 CWKS TANF Timed-Out Asst JUN-16 MO 69,539.00 69,539.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 11,600.00 11,600.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 228.00 228.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (218,443.00) (643,910.00) (862,353.00)CWKS Safety Net Asst JUN-16 MO (212,100.00) (212,100.00)CWKS TANF Timed-Out Asst JUN-16 MO (66,100.00) (66,100.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (2,800.00) (2,800.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 4,389.00 0.00 4,389.00 CWKS Safety Net Asst JUN-16 MO (46,640.00) (46,640.00)CWKS TANF Timed-Out Asst JUN-16 MO 3,439.00 3,439.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 8,800.00 8,800.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 228.00 228.00 Total Net Adjustments 4,389.00 (34,173.00) (29,784.00)

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 4,389.00 (34,173.00) (29,784.00)MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (535,570.00) (535,570.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (445,300.95) (445,300.95)CWKS Monthly MOE Subaccount Est. JUN-16 MO 469,467.00 469,467.00 Family Support Subaccount JUL-16 MO (161,122.64) (161,122.64)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 10,039.99 10,039.99 Family Support Subaccount FY14-15 Growth FY 2014-15 (79,514.11) (79,514.11)Child Poverty Subaccount Expenditure JUN-16 MO 120,376.00 120,376.00 Child Poverty Subaccount Recoup** JUN-16 MO (81,318.46) (81,318.46)Child Poverty Growth FY14-15** FY 2015-16 (33,502.57) (33,502.57)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 4,242.00 0.00 4,242.00 0.00 0.00

ARC Exp. JUN-16 MO 5,131.00 5,131.00 ARC Exp. Deferred*** JUN-16 MO (5,131.00) (5,131.00)EBT FS GA/GR APR-16 MO (997.26) (997.26)

0.00 0.00 Total Miscellaneous Adjustment 4,242.00 (737,443.00) (733,201.00)

TOTAL 192,108.00 445.00 192,553.00 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: KingsSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 30,800.00 30,800.00 KinGAP Asst SEP-16 MO 19,600.00 19,600.00

Total Advances 30,800.00 19,600.00 50,400.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 33,546.00 33,546.00 KinGAP Asst JUN-16 MO 21,843.00 21,843.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (30,200.00) (30,200.00)KinGAP Asst JUN-16 MO (17,500.00) (17,500.00)Net AdjustmentsFedGAP Asst JUN-16 MO 3,346.00 3,346.00 KinGAP Asst JUN-16 MO 4,343.00 4,343.00 Total Net Adjustments 3,346.00 4,343.00 7,689.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 3,346.00 4,343.00 7,689.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 1,238.00 1,238.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 1,238.00 1,238.00

TOTAL 34,146.00 25,181.00 59,327.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 34,146.00 34,146.00 CALWORKS Asst 192,108.00 (181,684.74) 10,423.26 CWKS Safety Net Asst 101,860.00 101,860.00 CWKS TANF Timed-Out Asst 61,639.00 61,639.00

0.00 0.00 0.00 KinGAP Asst 25,181.00 25,181.00 CWKS Recent Non-Citizens Mixed Cases 19,200.00 19,200.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 428.00 428.00 EBT FS GA/GR (997.26) (997.26)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 226,254.00 25,626.00 251,880.00 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: LakeSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 103,060.00 218,576.00 321,636.00 CWKS Safety Net Asst SEP-16 MO 48,200.00 48,200.00 CWKS TANF Timed-Out Asst SEP-16 MO 39,800.00 39,800.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 1,500.00 1,500.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 300.00 300.00 Total Advances 103,060.00 308,376.00 411,436.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 103,154.00 248,334.00 351,488.00 CWKS Safety Net Asst JUN-16 MO 53,777.00 53,777.00 CWKS TANF Timed-Out Asst JUN-16 MO 44,429.00 44,429.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 3,277.00 3,277.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 326.00 326.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (84,246.00) (248,334.00) (332,580.00)CWKS Safety Net Asst JUN-16 MO (44,800.00) (44,800.00)CWKS TANF Timed-Out Asst JUN-16 MO (38,300.00) (38,300.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,000.00) (1,000.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 18,908.00 0.00 18,908.00 CWKS Safety Net Asst JUN-16 MO 8,977.00 8,977.00 CWKS TANF Timed-Out Asst JUN-16 MO 6,129.00 6,129.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 2,277.00 2,277.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 326.00 326.00 Total Net Adjustments 18,908.00 17,709.00 36,617.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 18,908.00 17,709.00 36,617.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (203,265.00) (203,265.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (169,004.70) (169,004.70)CWKS Monthly MOE Subaccount Est. JUN-16 MO 178,176.00 178,176.00 Family Support Subaccount JUL-16 MO (61,150.74) (61,150.74)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (30,177.92) (30,177.92)Child Poverty Subaccount Expenditure JUN-16 MO 47,102.00 47,102.00 Child Poverty Subaccount Recoup** JUN-16 MO (30,862.74) (30,862.74)Child Poverty Growth FY14-15** FY 2015-16 (1,964.21) (1,964.21)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO (10,951.00) 0.00 (10,951.00)0.00 0.00

ARC Exp. JUN-16 MO 375.00 375.00 EBT FS GA/GR APR-16 MO (618.18) (618.18)

0.00 0.00 Total Miscellaneous Adjustment (10,951.00) (271,390.49) (282,341.49)

TOTAL 111,017.00 54,694.51 165,711.51 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: LakeSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 1,500.00 1,500.00 KinGAP Asst SEP-16 MO 4,000.00 4,000.00

Total Advances 1,500.00 4,000.00 5,500.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 1,603.00 1,603.00 KinGAP Asst JUN-16 MO 4,516.00 4,516.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (1,400.00) (1,400.00)KinGAP Asst JUN-16 MO (4,800.00) (4,800.00)Net AdjustmentsFedGAP Asst JUN-16 MO 203.00 203.00 KinGAP Asst JUN-16 MO (284.00) (284.00)Total Net Adjustments 203.00 (284.00) (81.00)Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 203.00 (284.00) (81.00)

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 1,703.00 3,716.00 5,419.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 1,703.00 1,703.00 CALWORKS Asst 111,017.00 (52,571.31) 58,445.69 CWKS Safety Net Asst 57,177.00 57,177.00 CWKS TANF Timed-Out Asst 45,929.00 45,929.00

0.00 0.00 0.00 KinGAP Asst 3,716.00 3,716.00 CWKS Recent Non-Citizens Mixed Cases 3,777.00 3,777.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 626.00 626.00 EBT FS GA/GR (618.18) (618.18)

0.00 0.00 ARC 375.00 375.00

0.00 0.00 TOTAL REMITTANCE 112,720.00 58,410.51 171,130.51 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: LassenSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 51,363.00 85,923.00 137,286.00 CWKS Safety Net Asst SEP-16 MO 30,300.00 30,300.00 CWKS TANF Timed-Out Asst SEP-16 MO 12,100.00 12,100.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 500.00 500.00 Total Advances 51,363.00 128,823.00 180,186.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 52,134.00 97,175.00 149,309.00 CWKS Safety Net Asst JUN-16 MO 33,829.00 33,829.00 CWKS TANF Timed-Out Asst JUN-16 MO 13,466.00 13,466.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 541.00 541.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (32,966.00) (97,175.00) (130,141.00)CWKS Safety Net Asst JUN-16 MO (28,700.00) (28,700.00)CWKS TANF Timed-Out Asst JUN-16 MO (12,600.00) (12,600.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (100.00) (100.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 19,168.00 0.00 19,168.00 CWKS Safety Net Asst JUN-16 MO 5,129.00 5,129.00 CWKS TANF Timed-Out Asst JUN-16 MO 866.00 866.00 CWKS Recent Non-Citizens Mixed Cases (100.00) (100.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 541.00 541.00 Total Net Adjustments 19,168.00 6,436.00 25,604.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 19,168.00 6,436.00 25,604.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (93,060.00) (93,060.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (77,374.65) (77,374.65)CWKS Monthly MOE Subaccount Est. JUN-16 MO 81,574.00 81,574.00 Family Support Subaccount JUL-16 MO (27,996.37) (27,996.37)Family Support Subaccount - Recoupment* APR-15 MO (2,382.54) (2,382.54)Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (13,816.22) (13,816.22)Child Poverty Subaccount Expenditure JUN-16 MO 21,105.00 21,105.00 Child Poverty Subaccount Recoup** JUN-16 MO (14,129.75) (14,129.75)Child Poverty Growth FY14-15** FY 2015-16 (6,975.25) (6,975.25)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (143.29) (143.29)0.00 0.00

Total Miscellaneous Adjustment 0.00 (133,199.07) (133,199.07)

TOTAL 70,531.00 2,059.93 72,590.93 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: LassenSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 4,000.00 4,000.00 KinGAP Asst SEP-16 MO 2,600.00 2,600.00

Total Advances 4,000.00 2,600.00 6,600.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 4,398.00 4,398.00 KinGAP Asst JUN-16 MO 2,887.00 2,887.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (4,000.00) (4,000.00)KinGAP Asst JUN-16 MO (2,600.00) (2,600.00)Net AdjustmentsFedGAP Asst JUN-16 MO 398.00 398.00 KinGAP Asst JUN-16 MO 287.00 287.00 Total Net Adjustments 398.00 287.00 685.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 398.00 287.00 685.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 4,398.00 2,887.00 7,285.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 4,398.00 4,398.00 CALWORKS Asst 70,531.00 (47,132.78) 23,398.22 CWKS Safety Net Asst 35,429.00 35,429.00 CWKS TANF Timed-Out Asst 12,966.00 12,966.00

0.00 0.00 0.00 KinGAP Asst 2,887.00 2,887.00 CWKS Recent Non-Citizens Mixed Cases (100.00) (100.00)

0.00 0.00 CWKS Recent Non-Citizens NonFederal 1,041.00 1,041.00 EBT FS GA/GR (143.29) (143.29)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 74,929.00 4,946.93 79,875.93 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Los AngelesSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 16,925,143.00 30,125,965.00 47,051,108.00 CWKS Safety Net Asst SEP-16 MO 9,057,500.00 9,057,500.00 CWKS TANF Timed-Out Asst SEP-16 MO 3,471,800.00 3,471,800.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 1,691,800.00 1,691,800.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 585,500.00 585,500.00 Total Advances 16,925,143.00 44,932,565.00 61,857,708.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 16,354,211.00 34,685,374.00 51,039,585.00 CWKS Safety Net Asst JUN-16 MO 10,053,956.00 10,053,956.00 CWKS TANF Timed-Out Asst JUN-16 MO 3,879,543.00 3,879,543.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,885,842.00 1,885,842.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 650,502.00 650,502.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (11,766,823.00) (34,685,374.00) (46,452,197.00)CWKS Safety Net Asst JUN-16 MO (8,875,500.00) (8,875,500.00)CWKS TANF Timed-Out Asst JUN-16 MO (3,487,800.00) (3,487,800.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (2,161,000.00) (2,161,000.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (659,100.00) (659,100.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 4,587,388.00 0.00 4,587,388.00 CWKS Safety Net Asst JUN-16 MO 1,178,456.00 1,178,456.00 CWKS TANF Timed-Out Asst JUN-16 MO 391,743.00 391,743.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (275,158.00) (275,158.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (8,598.00) (8,598.00)Total Net Adjustments 4,587,388.00 1,286,443.00 5,873,831.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 4,587,388.00 1,286,443.00 5,873,831.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (32,310,212.00) (32,310,212.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (26,864,386.45) (26,864,386.45)CWKS Monthly MOE Subaccount Est. JUN-16 MO 28,322,279.00 28,322,279.00 Family Support Subaccount JUL-16 MO (9,720,304.61) (9,720,304.61)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (4,796,975.39) (4,796,975.39)Child Poverty Subaccount Expenditure JUN-16 MO 7,471,691.00 7,471,691.00 Child Poverty Subaccount Recoup** JUN-16 MO (4,905,829.43) (4,905,829.43)Child Poverty Growth FY14-15** FY 2015-16 (2,565,861.57) (2,565,861.57)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 20,075.00 20,075.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 663,592.00 (2,583.00) 661,009.00 CWKs ARC (NON-MOE) JUN-16 MO 1,333.00 1,333.00 ARC Exp. JUN-16 MO 781,270.00 781,270.00 EBT FS GA/GR APR-16 MO (94,801.93) (94,801.93)

0.00 0.00 Total Miscellaneous Adjustment 663,592.00 (44,664,306.38) (44,000,714.38)

TOTAL 22,176,123.00 1,554,701.62 23,730,824.62 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Los AngelesSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 1,233,500.00 1,233,500.00 KinGAP Asst SEP-16 MO 2,199,400.00 2,199,400.00

Total Advances 1,233,500.00 2,199,400.00 3,432,900.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 1,345,332.00 1,345,332.00 KinGAP Asst JUN-16 MO 2,456,289.00 2,456,289.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (1,176,300.00) (1,176,300.00)KinGAP Asst JUN-16 MO (2,182,900.00) (2,182,900.00)Net AdjustmentsFedGAP Asst JUN-16 MO 169,032.00 169,032.00 KinGAP Asst JUN-16 MO 273,389.00 273,389.00 Total Net Adjustments 169,032.00 273,389.00 442,421.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 169,032.00 273,389.00 442,421.00

MISC. ADJUSTMENTFedGAP OP BEG 07/01/12 JUN-16 MO 36.00 36.00 KinGAP 18 Plus JUN-16 MO 42,353.00 20,655.00 63,008.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00

Fraud Recovery Incentive JUN-16 QTR 662,306.00 662,306.00 Total Miscellaneous Adjustment 704,695.00 20,655.00 725,350.00

TOTAL 2,107,227.00 2,493,444.00 4,600,671.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 1,444,921.00 1,444,921.00 CALWORKS Asst 22,176,123.00 (15,244,884.45) 6,931,238.55 CWKS Safety Net Asst 10,235,956.00 10,235,956.00 CWKS TANF Timed-Out Asst 3,863,543.00 3,863,543.00

0.00 0.00 0.00 KinGAP Asst 2,493,444.00 2,493,444.00 CWKS Recent Non-Citizens Mixed Cases 1,416,642.00 1,416,642.00 CWKS Recent Non-Citizens TANF Timed-Out 20,075.00 20,075.00 CWKS Recent Non-Citizens NonFederal 576,902.00 576,902.00 EBT FS GA/GR (94,801.93) (94,801.93)Fraud Recovery Incentive 662,306.00 662,306.00 ARC 781,270.00 781,270.00

0.00 0.00 TOTAL REMITTANCE 24,283,350.00 4,048,145.62 28,331,495.62 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MaderaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 267,267.00 695,794.00 963,061.00 CWKS Safety Net Asst SEP-16 MO 192,400.00 192,400.00 CWKS TANF Timed-Out Asst SEP-16 MO 82,000.00 82,000.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 5,800.00 5,800.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 500.00 500.00 Total Advances 267,267.00 976,494.00 1,243,761.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 291,075.00 788,555.00 1,079,630.00 CWKS Safety Net Asst JUN-16 MO 214,484.00 214,484.00 CWKS TANF Timed-Out Asst JUN-16 MO 91,676.00 91,676.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 6,503.00 6,503.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 920.00 920.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (267,513.00) (788,555.00) (1,056,068.00)CWKS Safety Net Asst JUN-16 MO (198,300.00) (198,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (83,000.00) (83,000.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (6,900.00) (6,900.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (700.00) (700.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 23,562.00 0.00 23,562.00 CWKS Safety Net Asst JUN-16 MO 16,184.00 16,184.00 CWKS TANF Timed-Out Asst JUN-16 MO 8,676.00 8,676.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (397.00) (397.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 220.00 220.00 Total Net Adjustments 23,562.00 24,683.00 48,245.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 23,562.00 24,683.00 48,245.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (633,977.00) (633,977.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (527,121.24) (527,121.24)CWKS Monthly MOE Subaccount Est. JUN-16 MO 555,727.00 555,727.00 Family Support Subaccount JUL-16 MO (190,727.57) (190,727.57)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (94,124.15) (94,124.15)Child Poverty Subaccount Expenditure JUN-16 MO 147,975.00 147,975.00 Child Poverty Subaccount Recoup** JUN-16 MO (96,260.04) (96,260.04)Child Poverty Growth FY14-15** FY 2015-16 (17,882.59) (17,882.59)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 389.00 0.00 389.00 0.00 0.00

ARC Exp. JUN-16 MO 19,891.00 19,891.00 ARC Exp. Deferred*** JUN-16 MO (19,891.00) (19,891.00)EBT FS GA/GR APR-16 MO (1,121.41) (1,121.41)

0.00 0.00 Total Miscellaneous Adjustment 389.00 (857,512.00) (857,123.00)

TOTAL 291,218.00 143,665.00 434,883.00 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MaderaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 16,100.00 16,100.00 KinGAP Asst SEP-16 MO 10,000.00 10,000.00

Total Advances 16,100.00 10,000.00 26,100.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 17,594.00 17,594.00 KinGAP Asst JUN-16 MO 11,141.00 11,141.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (15,600.00) (15,600.00)KinGAP Asst JUN-16 MO (9,200.00) (9,200.00)Net AdjustmentsFedGAP Asst JUN-16 MO 1,994.00 1,994.00 KinGAP Asst JUN-16 MO 1,941.00 1,941.00 Total Net Adjustments 1,994.00 1,941.00 3,935.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,994.00 1,941.00 3,935.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 354.00 0.00 354.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 354.00 0.00 354.00

TOTAL 18,448.00 11,941.00 30,389.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 18,448.00 18,448.00 CALWORKS Asst 291,218.00 (160,596.59) 130,621.41 CWKS Safety Net Asst 208,584.00 208,584.00 CWKS TANF Timed-Out Asst 90,676.00 90,676.00

0.00 0.00 0.00 KinGAP Asst 11,941.00 11,941.00 CWKS Recent Non-Citizens Mixed Cases 5,403.00 5,403.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 720.00 720.00 EBT FS GA/GR (1,121.41) (1,121.41)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 309,666.00 155,606.00 465,272.00 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MarinSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 63,834.00 152,945.00 216,779.00 CWKS Safety Net Asst SEP-16 MO 26,600.00 26,600.00 CWKS TANF Timed-Out Asst SEP-16 MO 24,900.00 24,900.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 21,600.00 21,600.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 2,000.00 2,000.00 Total Advances 63,834.00 228,045.00 291,879.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 77,565.00 164,505.00 242,070.00 CWKS Safety Net Asst JUN-16 MO 29,711.00 29,711.00 CWKS TANF Timed-Out Asst JUN-16 MO 27,774.00 27,774.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 24,122.00 24,122.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,275.00 2,275.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (55,807.00) (164,505.00) (220,312.00)CWKS Safety Net Asst JUN-16 MO (24,800.00) (24,800.00)CWKS TANF Timed-Out Asst JUN-16 MO (20,500.00) (20,500.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (23,200.00) (23,200.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (2,200.00) (2,200.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 21,758.00 0.00 21,758.00 CWKS Safety Net Asst JUN-16 MO 4,911.00 4,911.00 CWKS TANF Timed-Out Asst JUN-16 MO 7,274.00 7,274.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 922.00 922.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 75.00 75.00 Total Net Adjustments 21,758.00 13,182.00 34,940.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 21,758.00 13,182.00 34,940.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (167,191.00) (167,191.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (139,011.47) (139,011.47)CWKS Monthly MOE Subaccount Est. JUN-16 MO 146,555.00 146,555.00 Family Support Subaccount JUL-16 MO (50,298.33) (50,298.33)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (24,822.25) (24,822.25)Child Poverty Subaccount Expenditure JUN-16 MO 34,873.00 34,873.00 Child Poverty Subaccount Recoup** JUN-16 MO (25,385.52) (25,385.52)Child Poverty Growth FY14-15** FY 2015-16 (9,218.18) (9,218.18)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 1,368.00 0.00 1,368.00 0.00 0.00

ARC Exp. JUN-16 MO 1,372.00 1,372.00 EBT FS GA/GR APR-16 MO (570.12) (570.12)

0.00 0.00 Total Miscellaneous Adjustment 1,368.00 (233,696.87) (232,328.87)

TOTAL 86,960.00 7,530.13 94,490.13 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MarinSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst 0.00 0.00 KinGAP Asst SEP-16 MO 2,900.00 2,900.00

Total Advances 0.00 2,900.00 2,900.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO 3,292.00 3,292.00 Less: Advances 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO (3,000.00) (3,000.00)Net AdjustmentsFedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO 292.00 292.00 Total Net Adjustments 0.00 292.00 292.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 0.00 292.00 292.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 1,247.00 1,405.00 2,652.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 1,247.00 1,405.00 2,652.00

TOTAL 1,247.00 4,597.00 5,844.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 1,247.00 1,247.00 CALWORKS Asst 86,960.00 (81,553.75) 5,406.25 CWKS Safety Net Asst 31,511.00 31,511.00 CWKS TANF Timed-Out Asst 32,174.00 32,174.00

0.00 0.00 0.00 KinGAP Asst 4,597.00 4,597.00 CWKS Recent Non-Citizens Mixed Cases 22,522.00 22,522.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 2,075.00 2,075.00 EBT FS GA/GR (570.12) (570.12)

0.00 0.00 ARC 1,372.00 1,372.00

0.00 0.00 TOTAL REMITTANCE 88,207.00 12,127.13 100,334.13 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MariposaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 19,255.00 44,565.00 63,820.00 CWKS Safety Net Asst SEP-16 MO 13,300.00 13,300.00 CWKS TANF Timed-Out Asst SEP-16 MO 6,000.00 6,000.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 19,255.00 63,865.00 83,120.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 20,640.00 51,078.00 71,718.00 CWKS Safety Net Asst JUN-16 MO 14,821.00 14,821.00 CWKS TANF Timed-Out Asst JUN-16 MO 6,754.00 6,754.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (17,328.00) (51,078.00) (68,406.00)CWKS Safety Net Asst JUN-16 MO (15,800.00) (15,800.00)CWKS TANF Timed-Out Asst JUN-16 MO (6,700.00) (6,700.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 3,312.00 0.00 3,312.00 CWKS Safety Net Asst JUN-16 MO (979.00) (979.00)CWKS TANF Timed-Out Asst JUN-16 MO 54.00 54.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 3,312.00 (925.00) 2,387.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 3,312.00 (925.00) 2,387.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (42,557.00) (42,557.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (35,384.48) (35,384.48)CWKS Monthly MOE Subaccount Est. JUN-16 MO 37,305.00 37,305.00 Family Support Subaccount JUL-16 MO (12,803.12) (12,803.12)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (6,318.34) (6,318.34)Child Poverty Subaccount Expenditure JUN-16 MO 10,200.00 10,200.00 Child Poverty Subaccount Recoup** JUN-16 MO (6,461.73) (6,461.73)

0.00 0.00 0.00 0.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 119.00 0.00 119.00

0.00 0.00 ARC Exp. JUN-16 MO 179.00 179.00 EBT FS GA/GR APR-16 MO (105.46) (105.46)

0.00 0.00 Total Miscellaneous Adjustment 119.00 (55,946.13) (55,827.13)

TOTAL 22,686.00 6,993.87 29,679.87 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MariposaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 700.00 700.00 KinGAP Asst SEP-16 MO 2,600.00 2,600.00

Total Advances 700.00 2,600.00 3,300.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 742.00 742.00 KinGAP Asst JUN-16 MO 2,922.00 2,922.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (600.00) (600.00)KinGAP Asst JUN-16 MO (2,600.00) (2,600.00)Net AdjustmentsFedGAP Asst JUN-16 MO 142.00 142.00 KinGAP Asst JUN-16 MO 322.00 322.00 Total Net Adjustments 142.00 322.00 464.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 142.00 322.00 464.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 842.00 2,922.00 3,764.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 842.00 842.00 CALWORKS Asst 22,686.00 (11,454.67) 11,231.33 CWKS Safety Net Asst 12,321.00 12,321.00 CWKS TANF Timed-Out Asst 6,054.00 6,054.00

0.00 0.00 0.00 KinGAP Asst 2,922.00 2,922.00

0.00 0.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00

0.00 0.00 EBT FS GA/GR (105.46) (105.46)

0.00 0.00 ARC 179.00 179.00

0.00 0.00 TOTAL REMITTANCE 23,528.00 9,915.87 33,443.87 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MendocinoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 73,250.00 216,632.00 289,882.00 CWKS Safety Net Asst SEP-16 MO 68,300.00 68,300.00 CWKS TANF Timed-Out Asst SEP-16 MO 26,200.00 26,200.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 400.00 400.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 73,250.00 311,532.00 384,782.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 104,845.00 237,744.00 342,589.00 CWKS Safety Net Asst JUN-16 MO 76,131.00 76,131.00 CWKS TANF Timed-Out Asst JUN-16 MO 29,245.00 29,245.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 425.00 425.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (80,653.00) (237,744.00) (318,397.00)CWKS Safety Net Asst JUN-16 MO (66,300.00) (66,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (24,500.00) (24,500.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,400.00) (1,400.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 24,192.00 0.00 24,192.00 CWKS Safety Net Asst JUN-16 MO 9,831.00 9,831.00 CWKS TANF Timed-Out Asst JUN-16 MO 4,745.00 4,745.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (975.00) (975.00)CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 24,192.00 13,601.00 37,793.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 24,192.00 13,601.00 37,793.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (235,187.00) (235,187.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (195,546.24) (195,546.24)CWKS Monthly MOE Subaccount Est. JUN-16 MO 206,158.00 206,158.00 Family Support Subaccount JUL-16 MO (70,754.23) (70,754.23)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 5,742.89 5,742.89 Family Support Subaccount FY14-15 Growth FY 2014-15 (34,917.25) (34,917.25)Child Poverty Subaccount Expenditure JUN-16 MO 49,757.00 49,757.00 Child Poverty Subaccount Recoup** JUN-16 MO (35,709.61) (35,709.61)Child Poverty Growth FY14-15** FY 2015-16 (14,047.39) (14,047.39)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 ARC Exp. JUN-16 MO 7,100.00 7,100.00 ARC Exp. Deferred*** JUN-16 MO (7,100.00) (7,100.00)EBT FS GA/GR APR-16 MO (629.17) (629.17)

0.00 0.00 Total Miscellaneous Adjustment 0.00 (325,133.00) (325,133.00)

TOTAL 97,442.00 0.00 97,442.00 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MendocinoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 7,800.00 7,800.00 KinGAP Asst SEP-16 MO 15,700.00 15,700.00

Total Advances 7,800.00 15,700.00 23,500.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 8,504.00 8,504.00 KinGAP Asst JUN-16 MO 17,577.00 17,577.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (7,000.00) (7,000.00)KinGAP Asst JUN-16 MO (15,700.00) (15,700.00)Net AdjustmentsFedGAP Asst JUN-16 MO 1,504.00 1,504.00 KinGAP Asst JUN-16 MO 1,877.00 1,877.00 Total Net Adjustments 1,504.00 1,877.00 3,381.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,504.00 1,877.00 3,381.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 9,304.00 17,577.00 26,881.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 9,304.00 9,304.00 CALWORKS Asst 97,442.00 (107,871.83) (10,429.83)CWKS Safety Net Asst 78,131.00 78,131.00 CWKS TANF Timed-Out Asst 30,945.00 30,945.00

0.00 0.00 0.00 KinGAP Asst 17,577.00 17,577.00 CWKS Recent Non-Citizens Mixed Cases (575.00) (575.00)

0.00 0.00 0.00 0.00

EBT FS GA/GR (629.17) (629.17)0.00 0.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 106,746.00 17,577.00 124,323.00 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MercedSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 646,191.00 1,457,673.00 2,103,864.00 CWKS Safety Net Asst SEP-16 MO 551,400.00 551,400.00 CWKS TANF Timed-Out Asst SEP-16 MO 248,700.00 248,700.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 11,800.00 11,800.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 1,900.00 1,900.00 Total Advances 646,191.00 2,271,473.00 2,917,664.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 722,484.00 1,643,454.00 2,365,938.00 CWKS Safety Net Asst JUN-16 MO 614,451.00 614,451.00 CWKS TANF Timed-Out Asst JUN-16 MO 277,927.00 277,927.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 13,132.00 13,132.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,154.00 2,154.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (557,533.00) (1,643,454.00) (2,200,987.00)CWKS Safety Net Asst JUN-16 MO (542,900.00) (542,900.00)CWKS TANF Timed-Out Asst JUN-16 MO (233,900.00) (233,900.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (14,500.00) (14,500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (1,900.00) (1,900.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 164,951.00 0.00 164,951.00 CWKS Safety Net Asst JUN-16 MO 71,551.00 71,551.00 CWKS TANF Timed-Out Asst JUN-16 MO 44,027.00 44,027.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,368.00) (1,368.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 254.00 254.00 Total Net Adjustments 164,951.00 114,464.00 279,415.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 164,951.00 114,464.00 279,415.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (1,529,647.00) (1,529,647.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (1,271,827.80) (1,271,827.80)CWKS Monthly MOE Subaccount Est. JUN-16 MO 1,340,848.00 1,340,848.00 Family Support Subaccount JUL-16 MO (460,183.73) (460,183.73)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (227,100.91) (227,100.91)Child Poverty Subaccount Expenditure JUN-16 MO 347,727.00 347,727.00 Child Poverty Subaccount Recoup** JUN-16 MO (232,254.36) (232,254.36)Child Poverty Growth FY14-15** FY 2015-16 (115,472.64) (115,472.64)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (2,297.13) (2,297.13)0.00 0.00

Total Miscellaneous Adjustment 0.00 (2,150,208.57) (2,150,208.57)

TOTAL 811,142.00 235,728.43 1,046,870.43 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MercedSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 24,800.00 24,800.00 KinGAP Asst SEP-16 MO 24,400.00 24,400.00

Total Advances 24,800.00 24,400.00 49,200.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 37,739.00 37,739.00 KinGAP Asst JUN-16 MO 27,200.00 27,200.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (32,100.00) (32,100.00)KinGAP Asst JUN-16 MO (26,200.00) (26,200.00)Net AdjustmentsFedGAP Asst JUN-16 MO 5,639.00 5,639.00 KinGAP Asst JUN-16 MO 1,000.00 1,000.00 Total Net Adjustments 5,639.00 1,000.00 6,639.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 5,639.00 1,000.00 6,639.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 2,577.00 679.00 3,256.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 2,577.00 679.00 3,256.00

TOTAL 33,016.00 26,079.00 59,095.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 33,016.00 33,016.00 CALWORKS Asst 811,142.00 (690,238.44) 120,903.56 CWKS Safety Net Asst 622,951.00 622,951.00 CWKS TANF Timed-Out Asst 292,727.00 292,727.00

0.00 0.00 0.00 KinGAP Asst 26,079.00 26,079.00 CWKS Recent Non-Citizens Mixed Cases 10,432.00 10,432.00

0.00 0.00 CWKS Recent Non-Citizens NonFederal 2,154.00 2,154.00 EBT FS GA/GR (2,297.13) (2,297.13)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 844,158.00 261,807.43 1,105,965.43 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ModocSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 7,606.00 25,193.00 32,799.00 CWKS Safety Net Asst SEP-16 MO 9,500.00 9,500.00 CWKS TANF Timed-Out Asst SEP-16 MO 3,500.00 3,500.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 800.00 800.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 7,606.00 38,993.00 46,599.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 7,957.00 28,231.00 36,188.00 CWKS Safety Net Asst JUN-16 MO 10,590.00 10,590.00 CWKS TANF Timed-Out Asst JUN-16 MO 3,920.00 3,920.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,577.00 1,577.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (9,577.00) (28,231.00) (37,808.00)CWKS Safety Net Asst JUN-16 MO (7,300.00) (7,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (3,600.00) (3,600.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO (300.00) (300.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO (1,620.00) 0.00 (1,620.00)CWKS Safety Net Asst JUN-16 MO 3,290.00 3,290.00 CWKS TANF Timed-Out Asst JUN-16 MO 320.00 320.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,577.00 1,577.00 CWKS Recent Non-Citizens Nonfederal (300.00) (300.00)Total Net Adjustments (1,620.00) 4,887.00 3,267.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment (1,620.00) 4,887.00 3,267.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. 0.00 0.00 CWKS Monthly MOE Subaccount Act. 0.00 0.00 CWKS Monthly MOE Subaccount Est. 0.00 0.00 Family Support Subaccount 0.00 0.00 Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth 0.00 0.00 Child Poverty Subaccount Expenditure JUN-16 MO 5,626.00 5,626.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (45.63) (45.63)0.00 0.00

Total Miscellaneous Adjustment 0.00 5,580.37 5,580.37

TOTAL 5,986.00 49,460.37 55,446.37 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ModocSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 1,100.00 1,100.00 KinGAP Asst SEP-16 MO 900.00 900.00

Total Advances 1,100.00 900.00 2,000.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 1,242.00 1,242.00 KinGAP Asst JUN-16 MO 991.00 991.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (1,100.00) (1,100.00)KinGAP Asst JUN-16 MO (900.00) (900.00)Net AdjustmentsFedGAP Asst JUN-16 MO 142.00 142.00 KinGAP Asst JUN-16 MO 91.00 91.00 Total Net Adjustments 142.00 91.00 233.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 142.00 91.00 233.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 1,242.00 991.00 2,233.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 1,242.00 1,242.00 CALWORKS Asst 5,986.00 30,819.00 36,805.00 CWKS Safety Net Asst 12,790.00 12,790.00 CWKS TANF Timed-Out Asst 3,820.00 3,820.00

0.00 0.00 0.00 KinGAP Asst 991.00 991.00 CWKS Recent Non-Citizens Mixed Cases 2,377.00 2,377.00

0.00 0.00 CWKS Recent Non-Citizens NonFederal (300.00) (300.00)EBT FS GA/GR (45.63) (45.63)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 7,228.00 50,451.37 57,679.37 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MonoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 4,763.00 4,622.00 9,385.00 CWKS Safety Net Asst SEP-16 MO 1,900.00 1,900.00 CWKS TANF Timed-Out Asst 0.00 0.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 4,763.00 6,522.00 11,285.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 5,747.00 4,923.00 10,670.00 CWKS Safety Net Asst JUN-16 MO 2,130.00 2,130.00 CWKS TANF Timed-Out Asst 0.00 0.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (1,670.00) (4,923.00) (6,593.00)CWKS Safety Net Asst JUN-16 MO (1,900.00) (1,900.00)CWKS TANF Timed-Out Asst JUN-16 MO (400.00) (400.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 4,077.00 0.00 4,077.00 CWKS Safety Net Asst JUN-16 MO 230.00 230.00 CWKS TANF Timed-Out Asst (400.00) (400.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 4,077.00 (170.00) 3,907.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 4,077.00 (170.00) 3,907.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. 0.00 0.00 CWKS Monthly MOE Subaccount Act. 0.00 0.00 CWKS Monthly MOE Subaccount Est. 0.00 0.00 Family Support Subaccount 0.00 0.00 Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth 0.00 0.00 Child Poverty Subaccount Expenditure JUN-16 MO 1,345.00 1,345.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (40.83) (40.83)0.00 0.00

Total Miscellaneous Adjustment 0.00 1,304.17 1,304.17

TOTAL 8,840.00 7,656.17 16,496.17 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MonoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00

Total Advances 0.00 0.00 0.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00 Less: Advances 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00 Net AdjustmentsFedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00 Total Net Adjustments 0.00 0.00 0.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 0.00 0.00 0.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 0.00 0.00 0.00

AS SHOWN ON REMITTANCE ADVICES0.00 0.00

CALWORKS Asst 8,840.00 5,967.00 14,807.00 CWKS Safety Net Asst 2,130.00 2,130.00 CWKS TANF Timed-Out Asst (400.00) (400.00)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

EBT FS GA/GR (40.83) (40.83)0.00 0.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 8,840.00 7,656.17 16,496.17 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MontereySHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 32,702.00 1,327,737.00 1,360,439.00 CWKS Safety Net Asst SEP-16 MO 168,300.00 168,300.00 CWKS TANF Timed-Out Asst SEP-16 MO 101,500.00 101,500.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 8,300.00 8,300.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 2,300.00 2,300.00 Total Advances 32,702.00 1,608,137.00 1,640,839.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 54,796.00 1,488,585.00 1,543,381.00 CWKS Safety Net Asst JUN-16 MO 187,615.00 187,615.00 CWKS TANF Timed-Out Asst JUN-16 MO 113,431.00 113,431.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 9,287.00 9,287.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,596.00 2,596.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (527,045.00) (1,553,585.00) (2,080,630.00)CWKS Safety Net Asst JUN-16 MO (175,800.00) (175,800.00)CWKS TANF Timed-Out Asst JUN-16 MO (107,700.00) (107,700.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (11,700.00) (11,700.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (2,000.00) (2,000.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO (472,249.00) (65,000.00) (537,249.00)CWKS Safety Net Asst JUN-16 MO 11,815.00 11,815.00 CWKS TANF Timed-Out Asst JUN-16 MO 5,731.00 5,731.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (2,413.00) (2,413.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 596.00 596.00 Total Net Adjustments (472,249.00) (49,271.00) (521,520.00)

Calworks - Deferred Recoupment JUN-16 MO 439,547.00 439,547.00 Total Prior Period Adjustment (32,702.00) (49,271.00) (81,973.00)MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (1,060,709.00) (1,060,709.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (881,928.57) (881,928.57)CWKS Monthly MOE Subaccount Est. JUN-16 MO 929,790.00 929,790.00 Family Support Subaccount JUL-16 MO (319,107.02) (319,107.02)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (157,479.48) (157,479.48)Child Poverty Subaccount Expenditure JUN-16 MO 197,429.00 197,429.00 Child Poverty Subaccount Recoup** JUN-16 MO (161,053.03) (161,053.03)Child Poverty Growth FY14-15** FY 2015-16 (36,375.97) (36,375.97)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 302.00 302.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 4,894.00 0.00 4,894.00

0.00 0.00 ARC Exp. JUN-16 MO 6,173.00 6,173.00 EBT FS GA/GR APR-16 MO (2,283.68) (2,283.68)

0.00 0.00 Total Miscellaneous Adjustment 4,894.00 (1,485,242.75) (1,480,348.75)

TOTAL 4,894.00 73,623.25 78,517.25 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: MontereySHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 6,700.00 6,700.00 KinGAP Asst SEP-16 MO 11,700.00 11,700.00

Total Advances 6,700.00 11,700.00 18,400.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 7,355.00 7,355.00 KinGAP Asst JUN-16 MO 13,039.00 13,039.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (5,900.00) (5,900.00)KinGAP Asst JUN-16 MO (12,400.00) (12,400.00)Net AdjustmentsFedGAP Asst JUN-16 MO 1,455.00 1,455.00 KinGAP Asst JUN-16 MO 639.00 639.00 Total Net Adjustments 1,455.00 639.00 2,094.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,455.00 639.00 2,094.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 2,580.00 1,345.00 3,925.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 2,580.00 1,345.00 3,925.00

TOTAL 10,735.00 13,684.00 24,419.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 10,735.00 10,735.00 CALWORKS Asst 4,894.00 (226,697.07) (221,803.07)CWKS Safety Net Asst 180,115.00 180,115.00 CWKS TANF Timed-Out Asst 107,231.00 107,231.00

0.00 0.00 0.00 KinGAP Asst 13,684.00 13,684.00 CWKS Recent Non-Citizens Mixed Cases 5,887.00 5,887.00 CWKS Recent Non-Citizens TANF Timed-Out 302.00 302.00 CWKS Recent Non-Citizens NonFederal 2,896.00 2,896.00 EBT FS GA/GR (2,283.68) (2,283.68)

0.00 0.00 ARC 6,173.00 6,173.00

0.00 0.00 TOTAL REMITTANCE 15,629.00 87,307.25 102,936.25 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: NapaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 45,199.00 112,997.00 158,196.00 CWKS Safety Net Asst SEP-16 MO 14,900.00 14,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 17,000.00 17,000.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 3,300.00 3,300.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 1,400.00 1,400.00 Total Advances 45,199.00 149,597.00 194,796.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 50,194.00 129,342.00 179,536.00 CWKS Safety Net Asst JUN-16 MO 16,596.00 16,596.00 CWKS TANF Timed-Out Asst JUN-16 MO 25,635.00 25,635.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 3,722.00 3,722.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 1,597.00 1,597.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (43,879.00) (129,342.00) (173,221.00)CWKS Safety Net Asst JUN-16 MO (12,800.00) (12,800.00)CWKS TANF Timed-Out Asst JUN-16 MO (18,200.00) (18,200.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (4,900.00) (4,900.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (1,800.00) (1,800.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 6,315.00 0.00 6,315.00 CWKS Safety Net Asst JUN-16 MO 3,796.00 3,796.00 CWKS TANF Timed-Out Asst JUN-16 MO 7,435.00 7,435.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,178.00) (1,178.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (203.00) (203.00)Total Net Adjustments 6,315.00 9,850.00 16,165.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 6,315.00 9,850.00 16,165.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (106,115.00) (106,115.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (88,229.24) (88,229.24)CWKS Monthly MOE Subaccount Est. JUN-16 MO 93,017.00 93,017.00 Family Support Subaccount JUL-16 MO (31,923.87) (31,923.87)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (15,754.44) (15,754.44)Child Poverty Subaccount Expenditure JUN-16 MO 25,166.00 25,166.00 Child Poverty Subaccount Recoup** JUN-16 MO (16,111.97) (16,111.97)Child Poverty Growth FY14-15** FY 2015-16 (7,530.01) (7,530.01)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 4,550.00 0.00 4,550.00 0.00 0.00

ARC Exp. JUN-16 MO 7,546.00 7,546.00 ARC Exp. Deferred*** JUN-16 MO (7,546.00) (7,546.00)EBT FS GA/GR APR-16 MO (337.62) (337.62)

0.00 0.00 Total Miscellaneous Adjustment 4,550.00 (147,819.15) (143,269.15)

TOTAL 56,064.00 11,627.85 67,691.85 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: NapaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 500.00 500.00 KinGAP Asst SEP-16 MO 5,500.00 5,500.00

Total Advances 500.00 5,500.00 6,000.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 506.00 506.00 KinGAP Asst JUN-16 MO 6,191.00 6,191.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (500.00) (500.00)KinGAP Asst JUN-16 MO (4,900.00) (4,900.00)Net AdjustmentsFedGAP Asst JUN-16 MO 6.00 6.00 KinGAP Asst JUN-16 MO 1,291.00 1,291.00 Total Net Adjustments 6.00 1,291.00 1,297.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 6.00 1,291.00 1,297.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 651.00 651.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 651.00 651.00

TOTAL 506.00 7,442.00 7,948.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 506.00 506.00 CALWORKS Asst 56,064.00 (34,484.53) 21,579.47 CWKS Safety Net Asst 18,696.00 18,696.00 CWKS TANF Timed-Out Asst 24,435.00 24,435.00

0.00 0.00 0.00 KinGAP Asst 7,442.00 7,442.00 CWKS Recent Non-Citizens Mixed Cases 2,122.00 2,122.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 1,197.00 1,197.00 EBT FS GA/GR (337.62) (337.62)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 56,570.00 19,069.85 75,639.85 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: NevadaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 42,681.00 121,222.00 163,903.00 CWKS Safety Net Asst SEP-16 MO 24,300.00 24,300.00 CWKS TANF Timed-Out Asst SEP-16 MO 19,300.00 19,300.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 42,681.00 164,822.00 207,503.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 52,185.00 131,702.00 183,887.00 CWKS Safety Net Asst JUN-16 MO 27,063.00 27,063.00 CWKS TANF Timed-Out Asst JUN-16 MO 21,525.00 21,525.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (44,679.00) (131,702.00) (176,381.00)CWKS Safety Net Asst JUN-16 MO (24,700.00) (24,700.00)CWKS TANF Timed-Out Asst JUN-16 MO (22,600.00) (22,600.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 7,506.00 0.00 7,506.00 CWKS Safety Net Asst JUN-16 MO 2,363.00 2,363.00 CWKS TANF Timed-Out Asst JUN-16 MO (1,075.00) (1,075.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 7,506.00 1,288.00 8,794.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 7,506.00 1,288.00 8,794.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (131,303.00) (131,303.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (109,171.75) (109,171.75)CWKS Monthly MOE Subaccount Est. JUN-16 MO 115,096.00 115,096.00 Family Support Subaccount JUL-16 MO (39,501.47) (39,501.47)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 18,667.93 18,667.93 Family Support Subaccount FY14-15 Growth FY 2014-15 (19,493.99) (19,493.99)Child Poverty Subaccount Expenditure JUN-16 MO 24,742.00 24,742.00 Child Poverty Subaccount Recoup** JUN-16 MO (19,936.35) (19,936.35)Child Poverty Growth FY14-15** FY 2015-16 (4,206.81) (4,206.81)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (403.72) (403.72)0.00 0.00

Total Miscellaneous Adjustment 0.00 (165,511.16) (165,511.16)

TOTAL 50,187.00 598.84 50,785.84 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: NevadaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 4,200.00 4,200.00 KinGAP Asst SEP-16 MO 2,100.00 2,100.00

Total Advances 4,200.00 2,100.00 6,300.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 4,540.00 4,540.00 KinGAP Asst JUN-16 MO 2,310.00 2,310.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (3,400.00) (3,400.00)KinGAP Asst JUN-16 MO (2,100.00) (2,100.00)Net AdjustmentsFedGAP Asst JUN-16 MO 1,140.00 1,140.00 KinGAP Asst JUN-16 MO 210.00 210.00 Total Net Adjustments 1,140.00 210.00 1,350.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 2,840.00 210.00 1,350.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 430.00 0.00 430.00 0.00 0.00 0.00 0.00 0.00 0.00

FedGAP Adv MAR-16 MO 1,700.00 0.00 1,700.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 2,130.00 0.00 2,130.00

TOTAL 9,170.00 2,310.00 9,780.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 7,470.00 7,470.00 CALWORKS Asst 50,187.00 (43,885.44) 6,301.56 CWKS Safety Net Asst 26,663.00 26,663.00 CWKS TANF Timed-Out Asst 18,225.00 18,225.00

0.00 0.00 0.00 KinGAP Asst 2,310.00 2,310.00

0.00 0.00 0.00 0.00 0.00 0.00

EBT FS GA/GR (403.72) (403.72)0.00 0.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 57,657.00 2,908.84 60,565.84 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: OrangeSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 1,967,953.00 4,304,739.00 6,272,692.00 CWKS Safety Net Asst SEP-16 MO 620,600.00 620,600.00 CWKS TANF Timed-Out Asst SEP-16 MO 404,700.00 404,700.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 132,100.00 132,100.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 51,100.00 51,100.00 Total Advances 1,967,953.00 5,513,239.00 7,481,192.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 2,143,110.00 4,891,149.00 7,034,259.00 CWKS Safety Net Asst JUN-16 MO 691,774.00 691,774.00 CWKS TANF Timed-Out Asst JUN-16 MO 452,172.00 452,172.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 147,195.00 147,195.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 56,790.00 56,790.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (1,659,295.00) (4,891,149.00) (6,550,444.00)CWKS Safety Net Asst JUN-16 MO (654,600.00) (654,600.00)CWKS TANF Timed-Out Asst JUN-16 MO (395,400.00) (395,400.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (133,500.00) (133,500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (51,400.00) (51,400.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 483,815.00 0.00 483,815.00 CWKS Safety Net Asst JUN-16 MO 37,174.00 37,174.00 CWKS TANF Timed-Out Asst JUN-16 MO 56,772.00 56,772.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 13,695.00 13,695.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 5,390.00 5,390.00 Total Net Adjustments 483,815.00 113,031.00 596,846.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 483,815.00 113,031.00 596,846.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (4,075,952.00) (4,075,952.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (3,388,957.25) (3,388,957.25)CWKS Monthly MOE Subaccount Est. JUN-16 MO 3,572,871.00 3,572,871.00 Family Support Subaccount JUL-16 MO (1,226,221.82) (1,226,221.82)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 23,944.93 23,944.93 Family Support Subaccount FY14-15 Growth FY 2014-15 (605,141.10) (605,141.10)Child Poverty Subaccount Expenditure JUN-16 MO 912,229.00 912,229.00 Child Poverty Subaccount Recoup** JUN-16 MO (618,873.12) (618,873.12)Child Poverty Growth FY14-15** FY 2015-16 (293,355.88) (293,355.88)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 3,164.00 3,164.00 CWKS Diversion Asst JUN-16 MO 28,058.00 1,596.00 29,654.00 CWKs ARC (MOE) JUN-16 MO 68,411.00 1,333.00 69,744.00

0.00 0.00 ARC Exp. JUN-16 MO 81,399.00 81,399.00 EBT FS GA/GR APR-16 MO (12,709.76) (12,709.76)

0.00 0.00 Total Miscellaneous Adjustment 96,469.00 (5,624,674.00) (5,528,205.00)

TOTAL 2,548,237.00 1,596.00 2,549,833.00 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: OrangeSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 31,000.00 31,000.00 KinGAP Asst SEP-16 MO 128,100.00 128,100.00

Total Advances 31,000.00 128,100.00 159,100.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 33,825.00 33,825.00 KinGAP Asst JUN-16 MO 143,093.00 143,093.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (25,600.00) (25,600.00)KinGAP Asst JUN-16 MO (137,600.00) (137,600.00)Net AdjustmentsFedGAP Asst JUN-16 MO 8,225.00 8,225.00 KinGAP Asst JUN-16 MO 5,493.00 5,493.00 Total Net Adjustments 8,225.00 5,493.00 13,718.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 8,225.00 5,493.00 13,718.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 3,956.00 3,956.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 3,956.00 3,956.00

TOTAL 39,225.00 137,549.00 176,774.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 39,225.00 39,225.00 CALWORKS Asst 2,520,179.00 (1,393,384.24) 1,126,794.76 CWKS Safety Net Asst 657,774.00 657,774.00 CWKS TANF Timed-Out Asst 461,472.00 461,472.00 CWKS Diversion Asst 28,058.00 1,596.00 29,654.00 KinGAP Asst 137,549.00 137,549.00 CWKS Recent Non-Citizens Mixed Cases 145,795.00 145,795.00 CWKS Recent Non-Citizens TANF Timed-Out 3,164.00 3,164.00 CWKS Recent Non-Citizens NonFederal 56,490.00 56,490.00 EBT FS GA/GR (12,709.76) (12,709.76)

0.00 0.00 ARC 81,399.00 81,399.00

0.00 0.00 TOTAL REMITTANCE 2,587,462.00 139,145.00 2,726,607.00 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: PlacerSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 112,337.00 288,375.00 400,712.00 CWKS Safety Net Asst SEP-16 MO 59,400.00 59,400.00 CWKS TANF Timed-Out Asst SEP-16 MO 26,200.00 26,200.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 4,700.00 4,700.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 2,700.00 2,700.00 Total Advances 112,337.00 381,375.00 493,712.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 145,407.00 309,616.00 455,023.00 CWKS Safety Net Asst JUN-16 MO 65,658.00 65,658.00 CWKS TANF Timed-Out Asst JUN-16 MO 29,252.00 29,252.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 5,264.00 5,264.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,969.00 2,969.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (105,036.00) (309,616.00) (414,652.00)CWKS Safety Net Asst JUN-16 MO (65,700.00) (65,700.00)CWKS TANF Timed-Out Asst JUN-16 MO (30,800.00) (30,800.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (3,400.00) (3,400.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (3,100.00) (3,100.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 40,371.00 0.00 40,371.00 CWKS Safety Net Asst JUN-16 MO (42.00) (42.00)CWKS TANF Timed-Out Asst JUN-16 MO (1,548.00) (1,548.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,864.00 1,864.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO (131.00) (131.00)Total Net Adjustments 40,371.00 143.00 40,514.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 40,371.00 143.00 40,514.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (299,327.00) (299,327.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (248,876.10) (248,876.10)CWKS Monthly MOE Subaccount Est. JUN-16 MO 262,382.00 262,382.00 Family Support Subaccount JUL-16 MO (90,050.50) (90,050.50)Family Support Subaccount - Recoupment* APR-15 MO (35,000.00) (35,000.00)Family Support Subaccount - Deferment* JUL-16 MO 74,884.02 74,884.02 Family Support Subaccount FY14-15 Growth FY 2014-15 (44,439.97) (44,439.97)Child Poverty Subaccount Expenditure JUN-16 MO 59,915.00 59,915.00 Child Poverty Subaccount Recoup** JUN-16 MO (45,448.42) (45,448.42)Child Poverty Growth FY14-15** FY 2015-16 (14,466.58) (14,466.58)

0.00 0.00 CWKS Diversion Asst JUN-16 MO 4,273.00 0.00 4,273.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (1,090.45) (1,090.45)0.00 0.00

Total Miscellaneous Adjustment 4,273.00 (381,518.00) (377,245.00)

TOTAL 156,981.00 0.00 156,981.00 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: PlacerSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 5,400.00 5,400.00 KinGAP Asst SEP-16 MO 4,900.00 4,900.00

Total Advances 5,400.00 4,900.00 10,300.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 5,892.00 5,892.00 KinGAP Asst JUN-16 MO 5,519.00 5,519.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (5,800.00) (5,800.00)KinGAP Asst JUN-16 MO (7,100.00) (7,100.00)Net AdjustmentsFedGAP Asst JUN-16 MO 92.00 92.00 KinGAP Asst JUN-16 MO (1,581.00) (1,581.00)Total Net Adjustments 92.00 (1,581.00) (1,489.00)Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 92.00 (1,581.00) (1,489.00)

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 1,357.00 1,357.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00

Fraud Recovery Incentive JUN-16 QTR 26,519.00 26,519.00 Total Miscellaneous Adjustment 26,519.00 1,357.00 27,876.00

TOTAL 32,011.00 4,676.00 36,687.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 5,492.00 5,492.00 CALWORKS Asst 152,708.00 (92,052.55) 60,655.45 CWKS Safety Net Asst 59,358.00 59,358.00 CWKS TANF Timed-Out Asst 24,652.00 24,652.00 CWKS Diversion Asst 4,273.00 0.00 4,273.00 KinGAP Asst 4,676.00 4,676.00 CWKS Recent Non-Citizens Mixed Cases 6,564.00 6,564.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 2,569.00 2,569.00 EBT FS GA/GR (1,090.45) (1,090.45)Fraud Recovery Incentive 26,519.00 26,519.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 188,992.00 4,676.00 193,668.00 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: PlumasSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 7,292.00 41,507.00 48,799.00 CWKS Safety Net Asst SEP-16 MO 9,400.00 9,400.00 CWKS TANF Timed-Out Asst SEP-16 MO 6,300.00 6,300.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 7,292.00 57,207.00 64,499.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 6,542.00 47,833.00 54,375.00 CWKS Safety Net Asst JUN-16 MO 10,501.00 10,501.00 CWKS TANF Timed-Out Asst JUN-16 MO 6,493.00 6,493.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (16,227.00) (47,833.00) (64,060.00)CWKS Safety Net Asst JUN-16 MO (10,400.00) (10,400.00)CWKS TANF Timed-Out Asst JUN-16 MO (6,300.00) (6,300.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO (9,685.00) 0.00 (9,685.00)CWKS Safety Net Asst JUN-16 MO 101.00 101.00 CWKS TANF Timed-Out Asst JUN-16 MO 193.00 193.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments (9,685.00) 294.00 (9,391.00)

Calworks - Deferred Recoupment JUN-16 MO 2,393.00 2,393.00 Total Prior Period Adjustment (7,292.00) 294.00 (6,998.00)MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (36,634.00) (36,634.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (30,459.67) (30,459.67)CWKS Monthly MOE Subaccount Est. JUN-16 MO 32,113.00 32,113.00 Family Support Subaccount JUL-16 MO (11,021.18) (11,021.18)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (5,438.96) (5,438.96)Child Poverty Subaccount Expenditure JUN-16 MO 7,503.00 7,503.00 Child Poverty Subaccount Recoup** JUN-16 MO (5,562.38) (5,562.38)Child Poverty Growth FY14-15** FY 2015-16 (1,940.62) (1,940.62)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 ARC Exp. JUN-16 MO 23.00 23.00 EBT FS GA/GR APR-16 MO (111.64) (111.64)

0.00 0.00 Total Miscellaneous Adjustment 0.00 (51,529.45) (51,529.45)

TOTAL 0.00 5,971.55 5,971.55 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: PlumasSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 2,700.00 2,700.00 KinGAP Asst 0.00 0.00

Total Advances 2,700.00 0.00 2,700.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 2,924.00 2,924.00 KinGAP Asst 0.00 0.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (2,700.00) (2,700.00)KinGAP Asst 0.00 0.00 Net AdjustmentsFedGAP Asst JUN-16 MO 224.00 224.00 KinGAP Asst 0.00 0.00 Total Net Adjustments 224.00 0.00 224.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 224.00 0.00 224.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 859.00 0.00 859.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 859.00 0.00 859.00

TOTAL 3,783.00 0.00 3,783.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 3,783.00 3,783.00 CALWORKS Asst 0.00 (9,933.81) (9,933.81)CWKS Safety Net Asst 9,501.00 9,501.00 CWKS TANF Timed-Out Asst 6,493.00 6,493.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

EBT FS GA/GR (111.64) (111.64)0.00 0.00

ARC 23.00 23.00 0.00 0.00

TOTAL REMITTANCE 3,783.00 5,971.55 9,754.55 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: RiversideSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 2,470,324.00 5,910,227.00 8,380,551.00 CWKS Safety Net Asst SEP-16 MO 1,570,900.00 1,570,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 765,100.00 765,100.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 66,300.00 66,300.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 14,600.00 14,600.00 Total Advances 2,470,324.00 8,327,127.00 10,797,451.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 2,854,212.00 6,533,034.00 9,387,246.00 CWKS Safety Net Asst JUN-16 MO 1,741,937.00 1,741,937.00 CWKS TANF Timed-Out Asst JUN-16 MO 854,931.00 854,931.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 73,904.00 73,904.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 16,232.00 16,232.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (2,216,296.00) (6,533,034.00) (8,749,330.00)CWKS Safety Net Asst JUN-16 MO (1,582,200.00) (1,582,200.00)CWKS TANF Timed-Out Asst JUN-16 MO (741,100.00) (741,100.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (79,000.00) (79,000.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (11,900.00) (11,900.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 637,916.00 0.00 637,916.00 CWKS Safety Net Asst JUN-16 MO 159,737.00 159,737.00 CWKS TANF Timed-Out Asst JUN-16 MO 113,831.00 113,831.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (5,096.00) (5,096.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 4,332.00 4,332.00 Total Net Adjustments 637,916.00 272,804.00 910,720.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 637,916.00 272,804.00 910,720.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (6,136,991.00) (6,136,991.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (5,102,612.25) (5,102,612.25)CWKS Monthly MOE Subaccount Est. JUN-16 MO 5,379,524.00 5,379,524.00 Family Support Subaccount JUL-16 MO (1,846,271.29) (1,846,271.29)Family Support Subaccount - Recoupment* APR-15 MO (60,000.00) (60,000.00)Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (911,135.84) (911,135.84)Child Poverty Subaccount Expenditure JUN-16 MO 1,309,639.00 1,309,639.00 Child Poverty Subaccount Recoup** JUN-16 MO (931,811.56) (931,811.56)Child Poverty Growth FY14-15** FY 2015-16 (377,827.44) (377,827.44)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO (47.00) (47.00)CWKS Diversion Asst JUN-16 MO 631.00 1,660.00 2,291.00 CWKs ARC (MOE) JUN-16 MO 53,785.00 0.00 53,785.00

0.00 0.00 ARC Exp. JUN-16 MO 98,910.00 98,910.00 EBT FS GA/GR APR-16 MO (11,858.27) (11,858.27)

0.00 0.00 Total Miscellaneous Adjustment 54,416.00 (8,588,821.65) (8,534,405.65)

TOTAL 3,162,656.00 11,109.35 3,173,765.35 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: RiversideSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 166,000.00 166,000.00 KinGAP Asst SEP-16 MO 239,100.00 239,100.00

Total Advances 166,000.00 239,100.00 405,100.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 188,008.00 188,008.00 KinGAP Asst JUN-16 MO 266,988.00 266,988.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (152,200.00) (152,200.00)KinGAP Asst JUN-16 MO (257,300.00) (257,300.00)Net AdjustmentsFedGAP Asst JUN-16 MO 35,808.00 35,808.00 KinGAP Asst JUN-16 MO 9,688.00 9,688.00 Total Net Adjustments 35,808.00 9,688.00 45,496.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 35,808.00 9,688.00 45,496.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 3,787.00 6,649.00 10,436.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 3,787.00 6,649.00 10,436.00

TOTAL 205,595.00 255,437.00 461,032.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 205,595.00 205,595.00 CALWORKS Asst 3,162,025.00 (2,767,259.38) 394,765.62 CWKS Safety Net Asst 1,730,637.00 1,730,637.00 CWKS TANF Timed-Out Asst 878,931.00 878,931.00 CWKS Diversion Asst 631.00 1,660.00 2,291.00 KinGAP Asst 255,437.00 255,437.00 CWKS Recent Non-Citizens Mixed Cases 61,204.00 61,204.00 CWKS Recent Non-Citizens TANF Timed-Out (47.00) (47.00)CWKS Recent Non-Citizens NonFederal 18,932.00 18,932.00 EBT FS GA/GR (11,858.27) (11,858.27)

0.00 0.00 ARC 98,910.00 98,910.00

0.00 0.00 TOTAL REMITTANCE 3,368,251.00 266,546.35 3,634,797.35 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SacramentoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 2,530,456.00 4,804,390.00 7,334,846.00 CWKS Safety Net Asst SEP-16 MO 2,359,300.00 2,359,300.00 CWKS TANF Timed-Out Asst SEP-16 MO 731,500.00 731,500.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 232,900.00 232,900.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 179,900.00 179,900.00 Total Advances 2,530,456.00 8,307,990.00 10,838,446.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 2,617,623.00 5,534,363.00 8,151,986.00 CWKS Safety Net Asst JUN-16 MO 2,623,794.00 2,623,794.00 CWKS TANF Timed-Out Asst JUN-16 MO 817,454.00 817,454.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 259,613.00 259,613.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 199,841.00 199,841.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (1,877,502.00) (5,534,363.00) (7,411,865.00)CWKS Safety Net Asst JUN-16 MO (2,355,100.00) (2,355,100.00)CWKS TANF Timed-Out Asst JUN-16 MO (776,300.00) (776,300.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (207,500.00) (207,500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (170,000.00) (170,000.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 740,121.00 0.00 740,121.00 CWKS Safety Net Asst JUN-16 MO 268,694.00 268,694.00 CWKS TANF Timed-Out Asst JUN-16 MO 41,154.00 41,154.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 52,113.00 52,113.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 29,841.00 29,841.00 Total Net Adjustments 740,121.00 391,802.00 1,131,923.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 740,121.00 391,802.00 1,131,923.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (5,738,827.00) (5,738,827.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (4,771,557.97) (4,771,557.97)CWKS Monthly MOE Subaccount Est. JUN-16 MO 5,030,504.00 5,030,504.00 Family Support Subaccount JUL-16 MO (1,726,486.37) (1,726,486.37)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (852,021.92) (852,021.92)Child Poverty Subaccount Expenditure JUN-16 MO 1,280,298.00 1,280,298.00 Child Poverty Subaccount Recoup** JUN-16 MO (871,356.20) (871,356.20)Child Poverty Growth FY14-15** FY 2015-16 (408,941.80) (408,941.80)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 1,077.00 1,077.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 50,913.00 0.00 50,913.00

0.00 0.00 ARC Exp. JUN-16 MO 56,591.00 56,591.00 EBT FS GA/GR APR-16 MO (12,915.49) (12,915.49)

0.00 0.00 Total Miscellaneous Adjustment 50,913.00 (8,013,636.75) (7,962,723.75)

TOTAL 3,321,490.00 686,155.25 4,007,645.25 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SacramentoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 231,700.00 231,700.00 KinGAP Asst SEP-16 MO 40,400.00 40,400.00

Total Advances 231,700.00 40,400.00 272,100.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 252,707.00 252,707.00 KinGAP Asst JUN-16 MO 45,173.00 45,173.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (226,700.00) (226,700.00)KinGAP Asst JUN-16 MO (35,500.00) (35,500.00)Net AdjustmentsFedGAP Asst JUN-16 MO 26,007.00 26,007.00 KinGAP Asst JUN-16 MO 9,673.00 9,673.00 Total Net Adjustments 26,007.00 9,673.00 35,680.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 26,007.00 9,673.00 35,680.00

MISC. ADJUSTMENTFedGAP OP BEG 07/01/12 JUN-16 MO (1,303.00) (1,303.00)KinGAP 18 Plus JUN-16 MO 15,339.00 1,917.00 17,256.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00

Fraud Recovery Incentive JUN-16 QTR 41,498.00 41,498.00 Total Miscellaneous Adjustment 55,534.00 1,917.00 57,451.00

TOTAL 313,241.00 51,990.00 365,231.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 271,743.00 271,743.00 CALWORKS Asst 3,321,490.00 (3,253,999.26) 67,490.74 CWKS Safety Net Asst 2,627,994.00 2,627,994.00 CWKS TANF Timed-Out Asst 772,654.00 772,654.00

0.00 0.00 0.00 KinGAP Asst 51,990.00 51,990.00 CWKS Recent Non-Citizens Mixed Cases 285,013.00 285,013.00 CWKS Recent Non-Citizens TANF Timed-Out 1,077.00 1,077.00 CWKS Recent Non-Citizens NonFederal 209,741.00 209,741.00 EBT FS GA/GR (12,915.49) (12,915.49)Fraud Recovery Incentive 41,498.00 41,498.00 ARC 56,591.00 56,591.00

0.00 0.00 TOTAL REMITTANCE 3,634,731.00 738,145.25 4,372,876.25 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San BenitoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 36,545.00 111,412.00 147,957.00 CWKS Safety Net Asst SEP-16 MO 23,500.00 23,500.00 CWKS TANF Timed-Out Asst SEP-16 MO 11,700.00 11,700.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 1,600.00 1,600.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 36,545.00 148,212.00 184,757.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 45,578.00 119,153.00 164,731.00 CWKS Safety Net Asst JUN-16 MO 26,132.00 26,132.00 CWKS TANF Timed-Out Asst JUN-16 MO 13,104.00 13,104.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,668.00 1,668.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (40,422.00) (119,153.00) (159,575.00)CWKS Safety Net Asst JUN-16 MO (21,300.00) (21,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (12,000.00) (12,000.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (2,300.00) (2,300.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 5,156.00 0.00 5,156.00 CWKS Safety Net Asst JUN-16 MO 4,832.00 4,832.00 CWKS TANF Timed-Out Asst JUN-16 MO 1,104.00 1,104.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (632.00) (632.00)CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 5,156.00 5,304.00 10,460.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 5,156.00 5,304.00 10,460.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (122,515.00) (122,515.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (101,865.53) (101,865.53)CWKS Monthly MOE Subaccount Est. JUN-16 MO 107,394.00 107,394.00 Family Support Subaccount JUL-16 MO (36,857.87) (36,857.87)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 18,211.91 18,211.91 Family Support Subaccount FY14-15 Growth FY 2014-15 (18,189.38) (18,189.38)Child Poverty Subaccount Expenditure JUN-16 MO 21,995.00 21,995.00 Child Poverty Subaccount Recoup** JUN-16 MO (18,602.13) (18,602.13)

0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 ARC Exp. JUN-16 MO 550.00 550.00 EBT FS GA/GR APR-16 MO (244.13) (244.13)

0.00 0.00 Total Miscellaneous Adjustment 0.00 (150,123.13) (150,123.13)

TOTAL 41,701.00 3,392.87 45,093.87 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San BenitoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst 0.00 0.00 KinGAP Asst SEP-16 MO 2,600.00 2,600.00

Total Advances 0.00 2,600.00 2,600.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO 2,871.00 2,871.00 Less: Advances 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO (3,100.00) (3,100.00)Net AdjustmentsFedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO (229.00) (229.00)Total Net Adjustments 0.00 (229.00) (229.00)Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 0.00 (229.00) (229.00)

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 679.00 679.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 679.00 679.00

TOTAL 0.00 3,050.00 3,050.00

AS SHOWN ON REMITTANCE ADVICES0.00 0.00

CALWORKS Asst 41,701.00 (39,017.00) 2,684.00 CWKS Safety Net Asst 28,332.00 28,332.00 CWKS TANF Timed-Out Asst 12,804.00 12,804.00

0.00 0.00 0.00 KinGAP Asst 3,050.00 3,050.00 CWKS Recent Non-Citizens Mixed Cases 968.00 968.00

0.00 0.00 0.00 0.00

EBT FS GA/GR (244.13) (244.13)0.00 0.00

ARC 550.00 550.00 0.00 0.00

TOTAL REMITTANCE 41,701.00 6,442.87 48,143.87 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San BernardinoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 4,408,515.00 8,378,938.00 12,787,453.00 CWKS Safety Net Asst SEP-16 MO 3,330,900.00 3,330,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 1,560,800.00 1,560,800.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 89,400.00 89,400.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 19,900.00 19,900.00 Total Advances 4,408,515.00 13,379,938.00 17,788,453.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 4,607,546.00 9,623,980.00 14,231,526.00 CWKS Safety Net Asst JUN-16 MO 3,709,363.00 3,709,363.00 CWKS TANF Timed-Out Asst JUN-16 MO 1,744,073.00 1,744,073.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 99,608.00 99,608.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 22,107.00 22,107.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (3,264,882.00) (9,623,980.00) (12,888,862.00)CWKS Safety Net Asst JUN-16 MO (3,361,000.00) (3,361,000.00)CWKS TANF Timed-Out Asst JUN-16 MO (1,544,300.00) (1,544,300.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (96,500.00) (96,500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (19,800.00) (19,800.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 1,342,664.00 0.00 1,342,664.00 CWKS Safety Net Asst JUN-16 MO 348,363.00 348,363.00 CWKS TANF Timed-Out Asst JUN-16 MO 199,773.00 199,773.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 3,108.00 3,108.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,307.00 2,307.00 Total Net Adjustments 1,342,664.00 553,551.00 1,896,215.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,342,664.00 553,551.00 1,896,215.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (9,269,909.00) (9,269,909.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (7,707,482.32) (7,707,482.32)CWKS Monthly MOE Subaccount Est. JUN-16 MO 8,125,757.00 8,125,757.00 Family Support Subaccount JUL-16 MO (2,788,787.90) (2,788,787.90)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (1,376,268.28) (1,376,268.28)Child Poverty Subaccount Expenditure JUN-16 MO 2,104,588.00 2,104,588.00 Child Poverty Subaccount Recoup** JUN-16 MO (1,407,498.88) (1,407,498.88)Child Poverty Growth FY14-15** FY 2015-16 (697,089.12) (697,089.12)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 108.00 108.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (16,454.55) (16,454.55)CalWORKS EBT Theft JUN-16 MO 486.00 486.00 Total Miscellaneous Adjustment 0.00 (13,032,551.05) (13,032,551.05)

TOTAL 5,751,179.00 900,937.95 6,652,116.95 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San BernardinoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 333,300.00 333,300.00 KinGAP Asst SEP-16 MO 154,000.00 154,000.00

Total Advances 333,300.00 154,000.00 487,300.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 363,503.00 363,503.00 KinGAP Asst JUN-16 MO 172,033.00 172,033.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (267,800.00) (267,800.00)KinGAP Asst JUN-16 MO (169,700.00) (169,700.00)Net AdjustmentsFedGAP Asst JUN-16 MO 95,703.00 95,703.00 KinGAP Asst JUN-16 MO 2,333.00 2,333.00 Total Net Adjustments 95,703.00 2,333.00 98,036.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 95,703.00 2,333.00 98,036.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 6,044.00 5,487.00 11,531.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 6,044.00 5,487.00 11,531.00

TOTAL 435,047.00 161,820.00 596,867.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 435,047.00 435,047.00 CALWORKS Asst 5,751,179.00 (4,637,752.50) 1,113,426.50 CWKS Safety Net Asst 3,679,263.00 3,679,263.00 CWKS TANF Timed-Out Asst 1,760,573.00 1,760,573.00

0.00 0.00 0.00 KinGAP Asst 161,820.00 161,820.00 CWKS Recent Non-Citizens Mixed Cases 92,508.00 92,508.00

108.00 108.00 CWKS Recent Non-Citizens NonFederal 22,207.00 22,207.00 EBT FS GA/GR (16,454.55) (16,454.55)

0.00 0.00 0.00 0.00

CalWORKS EBT Theft 486.00 486.00 TOTAL REMITTANCE 6,186,226.00 1,062,757.95 7,248,983.95 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San DiegoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 2,344,376.00 5,111,719.00 7,456,095.00 CWKS Safety Net Asst SEP-16 MO 1,583,400.00 1,583,400.00 CWKS TANF Timed-Out Asst SEP-16 MO 827,800.00 827,800.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 219,600.00 219,600.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 59,400.00 59,400.00 Total Advances 2,344,376.00 7,801,919.00 10,146,295.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 2,530,945.00 5,817,149.00 8,348,094.00 CWKS Safety Net Asst JUN-16 MO 1,746,955.00 1,746,955.00 CWKS TANF Timed-Out Asst JUN-16 MO 925,001.00 925,001.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 244,742.00 244,742.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 65,951.00 65,951.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (1,973,436.00) (5,817,149.00) (7,790,585.00)CWKS Safety Net Asst JUN-16 MO (1,528,300.00) (1,528,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (840,700.00) (840,700.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (206,600.00) (206,600.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (50,100.00) (50,100.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 557,509.00 0.00 557,509.00 CWKS Safety Net Asst JUN-16 MO 218,655.00 218,655.00 CWKS TANF Timed-Out Asst JUN-16 MO 84,301.00 84,301.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 38,142.00 38,142.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 15,851.00 15,851.00 Total Net Adjustments 557,509.00 356,949.00 914,458.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 557,509.00 356,949.00 914,458.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (5,643,496.00) (5,643,496.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (4,692,294.64) (4,692,294.64)CWKS Monthly MOE Subaccount Est. JUN-16 MO 4,946,939.00 4,946,939.00 Family Support Subaccount JUL-16 MO (1,697,806.62) (1,697,806.62)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (837,868.45) (837,868.45)Child Poverty Subaccount Expenditure JUN-16 MO 1,230,572.00 1,230,572.00 Child Poverty Subaccount Recoup** JUN-16 MO (856,881.55) (856,881.55)Child Poverty Growth FY14-15** FY 2015-16 (373,690.45) (373,690.45)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 26,153.00 26,153.00 CWKS Diversion Asst JUN-16 MO 6,651.00 0.00 6,651.00 CWKs ARC (MOE) JUN-16 MO 124,473.00 0.00 124,473.00

0.00 0.00 ARC Exp. JUN-16 MO 128,191.00 128,191.00 EBT FS GA/GR APR-16 MO (14,317.01) (14,317.01)

0.00 0.00 Total Miscellaneous Adjustment 131,124.00 (7,784,499.72) (7,653,375.72)

TOTAL 3,033,009.00 374,368.28 3,407,377.28 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San DiegoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 92,700.00 92,700.00 KinGAP Asst SEP-16 MO 124,900.00 124,900.00

Total Advances 92,700.00 124,900.00 217,600.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 101,151.00 101,151.00 KinGAP Asst JUN-16 MO 139,513.00 139,513.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (90,100.00) (90,100.00)KinGAP Asst JUN-16 MO (122,700.00) (122,700.00)Net AdjustmentsFedGAP Asst JUN-16 MO 11,051.00 11,051.00 KinGAP Asst JUN-16 MO 16,813.00 16,813.00 Total Net Adjustments 11,051.00 16,813.00 27,864.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 11,051.00 16,813.00 27,864.00

MISC. ADJUSTMENTFedGAP OP BEG 07/01/12 JUN-16 MO (15,296.00) (15,296.00)KinGAP 18 Plus JUN-16 MO 1,138.00 4,952.00 6,090.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 CalWORKS EBT Theft OCT-15 MO 0.00 2,094.00 2,094.00

0.00 0.00 Fraud Recovery Incentive SEP-15 QTR 1,708.00 1,708.00 Fraud Recovery Incentive JUN-16 QTR 352.00 352.00 Total Miscellaneous Adjustment (12,098.00) 7,046.00 (5,052.00)

TOTAL 91,653.00 148,759.00 240,412.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 89,593.00 89,593.00 CALWORKS Asst 3,026,358.00 (2,812,807.71) 213,550.29 CWKS Safety Net Asst 1,802,055.00 1,802,055.00 CWKS TANF Timed-Out Asst 912,101.00 912,101.00 CWKS Diversion Asst 6,651.00 0.00 6,651.00 KinGAP Asst 146,665.00 146,665.00 CWKS Recent Non-Citizens Mixed Cases 257,742.00 257,742.00 CWKS Recent Non-Citizens TANF Timed-Out 26,153.00 26,153.00 CWKS Recent Non-Citizens NonFederal 75,251.00 75,251.00 EBT FS GA/GR (14,317.01) (14,317.01)Fraud Recovery Incentive 2,060.00 2,060.00 ARC 128,191.00 128,191.00 CalWORKS EBT Theft 2,094.00 2,094.00

TOTAL REMITTANCE 3,124,662.00 523,127.28 3,647,789.28 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San FranciscoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 320,881.00 671,563.00 992,444.00 CWKS Safety Net Asst SEP-16 MO 201,800.00 201,800.00 CWKS TANF Timed-Out Asst SEP-16 MO 145,200.00 145,200.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 44,200.00 44,200.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 14,400.00 14,400.00 Total Advances 320,881.00 1,077,163.00 1,398,044.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 330,576.00 776,139.00 1,106,715.00 CWKS Safety Net Asst JUN-16 MO 225,601.00 225,601.00 CWKS TANF Timed-Out Asst JUN-16 MO 162,299.00 162,299.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 49,299.00 49,299.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 19,474.00 19,474.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (263,301.00) (776,139.00) (1,039,440.00)CWKS Safety Net Asst JUN-16 MO (220,100.00) (220,100.00)CWKS TANF Timed-Out Asst JUN-16 MO (143,600.00) (143,600.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (43,900.00) (43,900.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (13,200.00) (13,200.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 67,275.00 0.00 67,275.00 CWKS Safety Net Asst JUN-16 MO 5,501.00 5,501.00 CWKS TANF Timed-Out Asst JUN-16 MO 18,699.00 18,699.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 5,399.00 5,399.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 6,274.00 6,274.00 Total Net Adjustments 67,275.00 35,873.00 103,148.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 67,275.00 35,873.00 103,148.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (767,170.00) (767,170.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (637,864.48) (637,864.48)CWKS Monthly MOE Subaccount Est. JUN-16 MO 672,481.00 672,481.00 Family Support Subaccount JUL-16 MO (230,797.64) (230,797.64)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (113,898.76) (113,898.76)Child Poverty Subaccount Expenditure JUN-16 MO 173,147.00 173,147.00 Child Poverty Subaccount Recoup** JUN-16 MO (116,483.37) (116,483.37)Child Poverty Growth FY14-15** FY 2015-16 (56,663.63) (56,663.63)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 2,321.00 2,321.00 CWKS Diversion Asst JUN-16 MO (904.00) 0.00 (904.00)CWKs ARC (MOE) JUN-16 MO 3,891.00 666.00 4,557.00

0.00 0.00 ARC Exp. JUN-16 MO 5,997.00 5,997.00 EBT FS GA/GR APR-16 MO (4,933.36) (4,933.36)

0.00 0.00 Total Miscellaneous Adjustment 2,987.00 (1,073,199.24) (1,070,212.24)

TOTAL 391,143.00 39,836.76 430,979.76 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San FranciscoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 139,500.00 139,500.00 KinGAP Asst SEP-16 MO 19,400.00 19,400.00

Total Advances 139,500.00 19,400.00 158,900.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 152,169.00 152,169.00 KinGAP Asst JUN-16 MO 21,624.00 21,624.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (135,800.00) (135,800.00)KinGAP Asst JUN-16 MO (20,600.00) (20,600.00)Net AdjustmentsFedGAP Asst JUN-16 MO 16,369.00 16,369.00 KinGAP Asst JUN-16 MO 1,024.00 1,024.00 Total Net Adjustments 16,369.00 1,024.00 17,393.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 16,369.00 1,024.00 17,393.00

MISC. ADJUSTMENTFedGAP OP BEG 07/01/12 JUN-16 MO (464.00) (464.00)KinGAP 18 Plus JUN-16 MO 9,338.00 2,502.00 11,840.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 8,874.00 2,502.00 11,376.00

TOTAL 164,743.00 22,926.00 187,669.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 164,743.00 164,743.00 CALWORKS Asst 392,047.00 (405,020.88) (12,973.88)CWKS Safety Net Asst 207,301.00 207,301.00 CWKS TANF Timed-Out Asst 163,899.00 163,899.00 CWKS Diversion Asst (904.00) 0.00 (904.00)KinGAP Asst 22,926.00 22,926.00 CWKS Recent Non-Citizens Mixed Cases 49,599.00 49,599.00 CWKS Recent Non-Citizens TANF Timed-Out 2,321.00 2,321.00 CWKS Recent Non-Citizens NonFederal 20,674.00 20,674.00 EBT FS GA/GR (4,933.36) (4,933.36)

0.00 0.00 ARC 5,997.00 5,997.00

0.00 0.00 TOTAL REMITTANCE 555,886.00 62,762.76 618,648.76 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San JoaquinSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 1,148,051.00 2,527,540.00 3,675,591.00 CWKS Safety Net Asst SEP-16 MO 1,207,100.00 1,207,100.00 CWKS TANF Timed-Out Asst SEP-16 MO 340,100.00 340,100.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 44,300.00 44,300.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 8,500.00 8,500.00 Total Advances 1,148,051.00 4,127,540.00 5,275,591.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 1,266,098.00 2,835,154.00 4,101,252.00 CWKS Safety Net Asst JUN-16 MO 1,345,834.00 1,345,834.00 CWKS TANF Timed-Out Asst JUN-16 MO 380,060.00 380,060.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 49,333.00 49,333.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 9,443.00 9,443.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (961,810.00) (2,835,154.00) (3,796,964.00)CWKS Safety Net Asst JUN-16 MO (1,194,900.00) (1,194,900.00)CWKS TANF Timed-Out Asst JUN-16 MO (350,500.00) (350,500.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (43,200.00) (43,200.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (5,800.00) (5,800.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 304,288.00 0.00 304,288.00 CWKS Safety Net Asst JUN-16 MO 150,934.00 150,934.00 CWKS TANF Timed-Out Asst JUN-16 MO 29,560.00 29,560.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 6,133.00 6,133.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 3,643.00 3,643.00 Total Net Adjustments 304,288.00 190,270.00 494,558.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 304,288.00 190,270.00 494,558.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (2,992,378.00) (2,992,378.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (2,488,018.10) (2,488,018.10)CWKS Monthly MOE Subaccount Est. JUN-16 MO 2,623,039.00 2,623,039.00 Family Support Subaccount JUL-16 MO (900,236.22) (900,236.22)Family Support Subaccount - Recoupment* APR-15 MO (128,190.43) (128,190.43)Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (444,267.04) (444,267.04)Child Poverty Subaccount Expenditure JUN-16 MO 627,262.00 627,262.00 Child Poverty Subaccount Recoup** JUN-16 MO (454,348.48) (454,348.48)Child Poverty Growth FY14-15** FY 2015-16 (172,913.52) (172,913.52)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 30,509.00 0.00 30,509.00 0.00 0.00

ARC Exp. JUN-16 MO 35,454.00 35,454.00 EBT FS GA/GR APR-16 MO (4,795.12) (4,795.12)

0.00 0.00 Total Miscellaneous Adjustment 30,509.00 (4,299,391.91) (4,268,882.91)

TOTAL 1,482,848.00 18,418.09 1,501,266.09 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San JoaquinSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 36,200.00 36,200.00 KinGAP Asst SEP-16 MO 35,400.00 35,400.00

Total Advances 36,200.00 35,400.00 71,600.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 39,443.00 39,443.00 KinGAP Asst JUN-16 MO 39,571.00 39,571.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (27,900.00) (27,900.00)KinGAP Asst JUN-16 MO (36,700.00) (36,700.00)Net AdjustmentsFedGAP Asst JUN-16 MO 11,543.00 11,543.00 KinGAP Asst JUN-16 MO 2,871.00 2,871.00 Total Net Adjustments 11,543.00 2,871.00 14,414.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 11,543.00 2,871.00 14,414.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 47,743.00 38,271.00 86,014.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 47,743.00 47,743.00 CALWORKS Asst 1,482,848.00 (1,802,510.79) (319,662.79)CWKS Safety Net Asst 1,358,034.00 1,358,034.00 CWKS TANF Timed-Out Asst 369,660.00 369,660.00

0.00 0.00 0.00 KinGAP Asst 38,271.00 38,271.00 CWKS Recent Non-Citizens Mixed Cases 50,433.00 50,433.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 12,143.00 12,143.00 EBT FS GA/GR (4,795.12) (4,795.12)

0.00 0.00 ARC 35,454.00 35,454.00

0.00 0.00 TOTAL REMITTANCE 1,530,591.00 56,689.09 1,587,280.09 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San Luis ObispoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 163,769.00 367,371.00 531,140.00 CWKS Safety Net Asst SEP-16 MO 65,700.00 65,700.00 CWKS TANF Timed-Out Asst SEP-16 MO 59,700.00 59,700.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 3,700.00 3,700.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 1,000.00 1,000.00 Total Advances 163,769.00 497,471.00 661,240.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 173,987.00 418,310.00 592,297.00 CWKS Safety Net Asst JUN-16 MO 73,209.00 73,209.00 CWKS TANF Timed-Out Asst JUN-16 MO 66,737.00 66,737.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 4,095.00 4,095.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 1,106.00 1,106.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (141,909.00) (418,310.00) (560,219.00)CWKS Safety Net Asst JUN-16 MO (70,700.00) (70,700.00)CWKS TANF Timed-Out Asst JUN-16 MO (54,000.00) (54,000.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (4,500.00) (4,500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (1,000.00) (1,000.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 32,078.00 0.00 32,078.00 CWKS Safety Net Asst JUN-16 MO 2,509.00 2,509.00 CWKS TANF Timed-Out Asst JUN-16 MO 12,737.00 12,737.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (405.00) (405.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 106.00 106.00 Total Net Adjustments 32,078.00 14,947.00 47,025.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 32,078.00 14,947.00 47,025.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (350,114.00) (350,114.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (291,102.89) (291,102.89)CWKS Monthly MOE Subaccount Est. JUN-16 MO 306,901.00 306,901.00 Family Support Subaccount JUL-16 MO (105,329.37) (105,329.37)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (51,980.10) (51,980.10)Child Poverty Subaccount Expenditure JUN-16 MO 80,020.00 80,020.00 Child Poverty Subaccount Recoup** JUN-16 MO (53,159.64) (53,159.64)Child Poverty Growth FY14-15** FY 2015-16 (26,860.36) (26,860.36)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 6,414.00 0.00 6,414.00 0.00 0.00

ARC Exp. JUN-16 MO 10,641.00 10,641.00 EBT FS GA/GR APR-16 MO (1,068.66) (1,068.66)

0.00 0.00 Total Miscellaneous Adjustment 6,414.00 (482,053.02) (475,639.02)

TOTAL 202,261.00 30,364.98 232,625.98 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San Luis ObispoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 20,200.00 20,200.00 KinGAP Asst SEP-16 MO 12,500.00 12,500.00

Total Advances 20,200.00 12,500.00 32,700.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 21,688.00 21,688.00 KinGAP Asst JUN-16 MO 13,911.00 13,911.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (17,900.00) (17,900.00)KinGAP Asst JUN-16 MO (12,500.00) (12,500.00)Net AdjustmentsFedGAP Asst JUN-16 MO 3,788.00 3,788.00 KinGAP Asst JUN-16 MO 1,411.00 1,411.00 Total Net Adjustments 3,788.00 1,411.00 5,199.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 3,788.00 1,411.00 5,199.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 1,357.00 1,357.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 1,357.00 1,357.00

TOTAL 23,988.00 15,268.00 39,256.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 23,988.00 23,988.00 CALWORKS Asst 202,261.00 (124,254.36) 78,006.64 CWKS Safety Net Asst 68,209.00 68,209.00 CWKS TANF Timed-Out Asst 72,437.00 72,437.00

0.00 0.00 0.00 KinGAP Asst 15,268.00 15,268.00 CWKS Recent Non-Citizens Mixed Cases 3,295.00 3,295.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 1,106.00 1,106.00 EBT FS GA/GR (1,068.66) (1,068.66)

0.00 0.00 ARC 10,641.00 10,641.00

0.00 0.00 TOTAL REMITTANCE 226,249.00 45,632.98 271,881.98 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San MateoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 110,447.00 346,883.00 457,330.00 CWKS Safety Net Asst SEP-16 MO 62,300.00 62,300.00 CWKS TANF Timed-Out Asst SEP-16 MO 47,200.00 47,200.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 26,200.00 26,200.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 2,000.00 2,000.00 Total Advances 110,447.00 484,583.00 595,030.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 152,230.00 373,739.00 525,969.00 CWKS Safety Net Asst JUN-16 MO 69,063.00 69,063.00 CWKS TANF Timed-Out Asst JUN-16 MO 52,796.00 52,796.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 29,227.00 29,227.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,251.00 2,251.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (126,789.00) (373,739.00) (500,528.00)CWKS Safety Net Asst JUN-16 MO (57,600.00) (57,600.00)CWKS TANF Timed-Out Asst JUN-16 MO (50,000.00) (50,000.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (33,200.00) (33,200.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (2,900.00) (2,900.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 25,441.00 0.00 25,441.00 CWKS Safety Net Asst JUN-16 MO 11,463.00 11,463.00 CWKS TANF Timed-Out Asst JUN-16 MO 2,796.00 2,796.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (3,973.00) (3,973.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (649.00) (649.00)Total Net Adjustments 25,441.00 9,637.00 35,078.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 25,441.00 9,637.00 35,078.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (441,955.00) (441,955.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (367,464.09) (367,464.09)CWKS Monthly MOE Subaccount Est. JUN-16 MO 387,406.00 387,406.00 Family Support Subaccount JUL-16 MO (132,959.03) (132,959.03)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 123,554.09 123,554.09 Family Support Subaccount FY14-15 Growth FY 2014-15 (65,615.35) (65,615.35)Child Poverty Subaccount Expenditure JUN-16 MO 72,865.00 72,865.00 Child Poverty Subaccount Recoup** JUN-16 MO (67,104.33) (67,104.33)

0.00 0.00 0.00 0.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 3,896.00 0.00 3,896.00

0.00 0.00 ARC Exp. JUN-16 MO 4,418.00 4,418.00 EBT FS GA/GR APR-16 MO (1,604.62) (1,604.62)

0.00 0.00 Total Miscellaneous Adjustment 3,896.00 (488,459.33) (484,563.33)

TOTAL 139,784.00 5,760.67 145,544.67 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: San MateoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 18,400.00 18,400.00 KinGAP Asst SEP-16 MO 5,100.00 5,100.00

Total Advances 18,400.00 5,100.00 23,500.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 20,025.00 20,025.00 KinGAP Asst JUN-16 MO 5,701.00 5,701.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (17,900.00) (17,900.00)KinGAP Asst JUN-16 MO (3,600.00) (3,600.00)Net AdjustmentsFedGAP Asst JUN-16 MO 2,125.00 2,125.00 KinGAP Asst JUN-16 MO 2,101.00 2,101.00 Total Net Adjustments 2,125.00 2,101.00 4,226.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 2,125.00 2,101.00 4,226.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 430.00 0.00 430.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 430.00 0.00 430.00

TOTAL 20,955.00 7,201.00 28,156.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 20,955.00 20,955.00 CALWORKS Asst 139,784.00 (144,389.71) (4,605.71)CWKS Safety Net Asst 73,763.00 73,763.00 CWKS TANF Timed-Out Asst 49,996.00 49,996.00

0.00 0.00 0.00 KinGAP Asst 7,201.00 7,201.00 CWKS Recent Non-Citizens Mixed Cases 22,227.00 22,227.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 1,351.00 1,351.00 EBT FS GA/GR (1,604.62) (1,604.62)

0.00 0.00 ARC 4,418.00 4,418.00

0.00 0.00 TOTAL REMITTANCE 160,739.00 12,961.67 173,700.67 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Santa BarbaraSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 208,566.00 927,596.00 1,136,162.00 CWKS Safety Net Asst SEP-16 MO 143,400.00 143,400.00 CWKS TANF Timed-Out Asst SEP-16 MO 100,800.00 100,800.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 7,200.00 7,200.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 2,100.00 2,100.00 Total Advances 208,566.00 1,181,096.00 1,389,662.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 238,981.00 1,058,956.00 1,297,937.00 CWKS Safety Net Asst JUN-16 MO 155,437.00 155,437.00 CWKS TANF Timed-Out Asst JUN-16 MO 112,636.00 112,636.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 8,052.00 8,052.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,348.00 2,348.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (359,245.00) (1,058,956.00) (1,418,201.00)CWKS Safety Net Asst JUN-16 MO (162,200.00) (162,200.00)CWKS TANF Timed-Out Asst JUN-16 MO (85,900.00) (85,900.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (5,200.00) (5,200.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (2,800.00) (2,800.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO (120,264.00) 0.00 (120,264.00)CWKS Safety Net Asst JUN-16 MO (6,763.00) (6,763.00)CWKS TANF Timed-Out Asst JUN-16 MO 26,736.00 26,736.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 2,852.00 2,852.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO (452.00) (452.00)Total Net Adjustments (120,264.00) 22,373.00 (97,891.00)

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment (120,264.00) 22,373.00 (97,891.00)MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (776,164.00) (776,164.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (645,342.86) (645,342.86)CWKS Monthly MOE Subaccount Est. JUN-16 MO 680,365.00 680,365.00 Family Support Subaccount JUL-16 MO (233,503.53) (233,503.53)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (115,234.12) (115,234.12)Child Poverty Subaccount Expenditure JUN-16 MO 169,002.00 169,002.00 Child Poverty Subaccount Recoup** JUN-16 MO (117,849.05) (117,849.05)Child Poverty Growth FY14-15** FY 2015-16 (51,152.95) (51,152.95)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 302.00 302.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 7,302.00 0.00 7,302.00

0.00 0.00 ARC Exp. JUN-16 MO 6,997.00 6,997.00 EBT FS GA/GR APR-16 MO (1,957.57) (1,957.57)

0.00 0.00 Total Miscellaneous Adjustment 7,302.00 (1,084,538.08) (1,077,236.08)

TOTAL 95,604.00 118,930.92 214,534.92 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Santa BarbaraSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 10,900.00 10,900.00 KinGAP Asst SEP-16 MO 14,700.00 14,700.00

Total Advances 10,900.00 14,700.00 25,600.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 11,913.00 11,913.00 KinGAP Asst JUN-16 MO 16,419.00 16,419.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (10,100.00) (10,100.00)KinGAP Asst JUN-16 MO (14,100.00) (14,100.00)Net AdjustmentsFedGAP Asst JUN-16 MO 1,813.00 1,813.00 KinGAP Asst JUN-16 MO 2,319.00 2,319.00 Total Net Adjustments 1,813.00 2,319.00 4,132.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,813.00 2,319.00 4,132.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 430.00 2,241.00 2,671.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 430.00 2,241.00 2,671.00

TOTAL 13,143.00 19,260.00 32,403.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 13,143.00 13,143.00 CALWORKS Asst 95,604.00 (162,283.51) (66,679.51)CWKS Safety Net Asst 136,637.00 136,637.00 CWKS TANF Timed-Out Asst 127,536.00 127,536.00

0.00 0.00 0.00 KinGAP Asst 19,260.00 19,260.00 CWKS Recent Non-Citizens Mixed Cases 10,052.00 10,052.00 CWKS Recent Non-Citizens TANF Timed-Out 302.00 302.00 CWKS Recent Non-Citizens NonFederal 1,648.00 1,648.00 EBT FS GA/GR (1,957.57) (1,957.57)

0.00 0.00 ARC 6,997.00 6,997.00

0.00 0.00 TOTAL REMITTANCE 108,747.00 138,190.92 246,937.92 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Santa ClaraSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 519,882.00 1,689,090.00 2,208,972.00 CWKS Safety Net Asst SEP-16 MO 453,900.00 453,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 207,100.00 207,100.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 32,400.00 32,400.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 16,100.00 16,100.00 Total Advances 519,882.00 2,398,590.00 2,918,472.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 776,217.00 1,757,559.00 2,533,776.00 CWKS Safety Net Asst JUN-16 MO 504,333.00 504,333.00 CWKS TANF Timed-Out Asst JUN-16 MO 231,452.00 231,452.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 36,094.00 36,094.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 17,901.00 17,901.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (596,242.00) (1,757,559.00) (2,353,801.00)CWKS Safety Net Asst JUN-16 MO (452,800.00) (452,800.00)CWKS TANF Timed-Out Asst JUN-16 MO (223,300.00) (223,300.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (45,300.00) (45,300.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (10,300.00) (10,300.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 179,975.00 0.00 179,975.00 CWKS Safety Net Asst JUN-16 MO 51,533.00 51,533.00 CWKS TANF Timed-Out Asst JUN-16 MO 8,152.00 8,152.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (9,206.00) (9,206.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 7,601.00 7,601.00 Total Net Adjustments 179,975.00 58,080.00 238,055.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 179,975.00 58,080.00 238,055.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (2,073,108.00) (2,073,108.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (1,723,689.50) (1,723,689.50)CWKS Monthly MOE Subaccount Est. JUN-16 MO 1,817,232.00 1,817,232.00 Family Support Subaccount JUL-16 MO (623,680.24) (623,680.24)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 433,697.38 433,697.38 Family Support Subaccount FY14-15 Growth FY 2014-15 (307,786.52) (307,786.52)Child Poverty Subaccount Expenditure JUN-16 MO 369,252.00 369,252.00 Child Poverty Subaccount Recoup** JUN-16 MO (314,770.88) (314,770.88)

0.00 0.00 CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 611.00 611.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 23,846.00 333.00 24,179.00

0.00 0.00 ARC Exp. JUN-16 MO 26,426.00 26,426.00 EBT FS GA/GR APR-16 MO (6,705.12) (6,705.12)

0.00 0.00 Total Miscellaneous Adjustment 23,846.00 (2,402,188.88) (2,378,342.88)

TOTAL 723,703.00 54,481.12 778,184.12 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Santa ClaraSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 41,900.00 41,900.00 KinGAP Asst SEP-16 MO 103,200.00 103,200.00

Total Advances 41,900.00 103,200.00 145,100.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 45,712.00 45,712.00 KinGAP Asst JUN-16 MO 115,276.00 115,276.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (39,400.00) (39,400.00)KinGAP Asst JUN-16 MO (94,800.00) (94,800.00)Net AdjustmentsFedGAP Asst JUN-16 MO 6,312.00 6,312.00 KinGAP Asst JUN-16 MO 20,476.00 20,476.00 Total Net Adjustments 6,312.00 20,476.00 26,788.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 6,312.00 20,476.00 26,788.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 2,230.00 3,245.00 5,475.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00

Fraud Recovery Incentive SEP-15 QTR 176.00 176.00 Fraud Recovery Incentive JUN-16 QTR 100,254.00 100,254.00 Total Miscellaneous Adjustment 102,660.00 3,245.00 105,905.00

TOTAL 150,872.00 126,921.00 277,793.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 50,442.00 50,442.00 CALWORKS Asst 723,703.00 (733,430.76) (9,727.76)CWKS Safety Net Asst 505,433.00 505,433.00 CWKS TANF Timed-Out Asst 215,252.00 215,252.00

0.00 0.00 0.00 KinGAP Asst 126,921.00 126,921.00 CWKS Recent Non-Citizens Mixed Cases 23,194.00 23,194.00 CWKS Recent Non-Citizens TANF Timed-Out 611.00 611.00 CWKS Recent Non-Citizens NonFederal 23,701.00 23,701.00 EBT FS GA/GR (6,705.12) (6,705.12)Fraud Recovery Incentive 100,430.00 100,430.00 ARC 26,426.00 26,426.00

0.00 0.00 TOTAL REMITTANCE 874,575.00 181,402.12 1,055,977.12 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Santa CruzSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 135,761.00 357,412.00 493,173.00 CWKS Safety Net Asst SEP-16 MO 69,900.00 69,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 83,500.00 83,500.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 2,700.00 2,700.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 135,761.00 513,512.00 649,273.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 129,869.00 406,409.00 536,278.00 CWKS Safety Net Asst JUN-16 MO 77,952.00 77,952.00 CWKS TANF Timed-Out Asst JUN-16 MO 93,350.00 93,350.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 5,081.00 5,081.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (137,872.00) (406,409.00) (544,281.00)CWKS Safety Net Asst JUN-16 MO (70,700.00) (70,700.00)CWKS TANF Timed-Out Asst JUN-16 MO (85,900.00) (85,900.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (2,300.00) (2,300.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO (8,003.00) 0.00 (8,003.00)CWKS Safety Net Asst JUN-16 MO 7,252.00 7,252.00 CWKS TANF Timed-Out Asst JUN-16 MO 7,450.00 7,450.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 2,781.00 2,781.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments (8,003.00) 17,483.00 9,480.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment (8,003.00) 17,483.00 9,480.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (363,888.00) (363,888.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (302,555.38) (302,555.38)CWKS Monthly MOE Subaccount Est. JUN-16 MO 318,975.00 318,975.00 Family Support Subaccount JUL-16 MO (109,473.20) (109,473.20)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (54,025.08) (54,025.08)Child Poverty Subaccount Expenditure JUN-16 MO 77,021.00 77,021.00 Child Poverty Subaccount Recoup** JUN-16 MO (55,251.02) (55,251.02)Child Poverty Growth FY14-15** FY 2015-16 (21,769.98) (21,769.98)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 7,735.00 0.00 7,735.00 0.00 0.00

ARC Exp. JUN-16 MO 10,387.00 10,387.00 EBT FS GA/GR APR-16 MO (1,453.64) (1,453.64)

0.00 0.00 Total Miscellaneous Adjustment 7,735.00 (502,033.30) (494,298.30)

TOTAL 135,493.00 28,961.70 164,454.70 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: Santa CruzSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 16,600.00 16,600.00 KinGAP Asst SEP-16 MO 5,100.00 5,100.00

Total Advances 16,600.00 5,100.00 21,700.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 18,104.00 18,104.00 KinGAP Asst JUN-16 MO 5,701.00 5,701.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (13,100.00) (13,100.00)KinGAP Asst JUN-16 MO (5,100.00) (5,100.00)Net AdjustmentsFedGAP Asst JUN-16 MO 5,004.00 5,004.00 KinGAP Asst JUN-16 MO 601.00 601.00 Total Net Adjustments 5,004.00 601.00 5,605.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 5,004.00 601.00 5,605.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 829.00 1,203.00 2,032.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 829.00 1,203.00 2,032.00

TOTAL 22,433.00 6,904.00 29,337.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 22,433.00 22,433.00 CALWORKS Asst 135,493.00 (153,554.66) (18,061.66)CWKS Safety Net Asst 77,152.00 77,152.00 CWKS TANF Timed-Out Asst 90,950.00 90,950.00

0.00 0.00 0.00 KinGAP Asst 6,904.00 6,904.00 CWKS Recent Non-Citizens Mixed Cases 5,481.00 5,481.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00

0.00 0.00 EBT FS GA/GR (1,453.64) (1,453.64)

0.00 0.00 ARC 10,387.00 10,387.00

0.00 0.00 TOTAL REMITTANCE 157,926.00 35,865.70 193,791.70 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ShastaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 212,078.00 482,559.00 694,637.00 CWKS Safety Net Asst SEP-16 MO 139,300.00 139,300.00 CWKS TANF Timed-Out Asst SEP-16 MO 69,400.00 69,400.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 1,700.00 1,700.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 212,078.00 692,959.00 905,037.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 269,404.00 528,303.00 797,707.00 CWKS Safety Net Asst JUN-16 MO 155,264.00 155,264.00 CWKS TANF Timed-Out Asst JUN-16 MO 77,498.00 77,498.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,948.00 1,948.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (179,224.00) (528,303.00) (707,527.00)CWKS Safety Net Asst JUN-16 MO (134,000.00) (134,000.00)CWKS TANF Timed-Out Asst JUN-16 MO (71,400.00) (71,400.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (2,200.00) (2,200.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (300.00) (300.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 90,180.00 0.00 90,180.00 CWKS Safety Net Asst JUN-16 MO 21,264.00 21,264.00 CWKS TANF Timed-Out Asst JUN-16 MO 6,098.00 6,098.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (252.00) (252.00)CWKS Recent Non-Citizens Nonfederal (300.00) (300.00)Total Net Adjustments 90,180.00 26,810.00 116,990.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 90,180.00 26,810.00 116,990.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (517,686.00) (517,686.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (430,430.70) (430,430.70)CWKS Monthly MOE Subaccount Est. JUN-16 MO 453,790.00 453,790.00 Family Support Subaccount JUL-16 MO (155,742.16) (155,742.16)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 6,615.18 6,615.18 Family Support Subaccount FY14-15 Growth FY 2014-15 (76,858.84) (76,858.84)Child Poverty Subaccount Expenditure JUN-16 MO 112,026.00 112,026.00 Child Poverty Subaccount Recoup** JUN-16 MO (78,602.93) (78,602.93)Child Poverty Growth FY14-15** FY 2015-16 (33,423.07) (33,423.07)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 7,361.00 0.00 7,361.00 0.00 0.00

ARC Exp. JUN-16 MO 8,616.00 8,616.00 ARC Exp. Deferred*** JUN-16 MO (6,874.00) (6,874.00)EBT FS GA/GR APR-16 MO (1,198.48) (1,198.48)

0.00 0.00 Total Miscellaneous Adjustment 7,361.00 (719,769.00) (712,408.00)

TOTAL 309,619.00 0.00 309,619.00 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ShastaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 19,900.00 19,900.00 KinGAP Asst SEP-16 MO 18,700.00 18,700.00

Total Advances 19,900.00 18,700.00 38,600.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 21,695.00 21,695.00 KinGAP Asst JUN-16 MO 20,842.00 20,842.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (19,000.00) (19,000.00)KinGAP Asst JUN-16 MO (18,600.00) (18,600.00)Net AdjustmentsFedGAP Asst JUN-16 MO 2,695.00 2,695.00 KinGAP Asst JUN-16 MO 2,242.00 2,242.00 Total Net Adjustments 2,695.00 2,242.00 4,937.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 2,695.00 2,242.00 4,937.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 430.00 679.00 1,109.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00

Fraud Recovery Incentive JUN-16 QTR 56,982.00 56,982.00 Total Miscellaneous Adjustment 57,412.00 679.00 58,091.00

TOTAL 80,007.00 21,621.00 101,628.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 23,025.00 23,025.00 CALWORKS Asst 309,619.00 (237,753.52) 71,865.48 CWKS Safety Net Asst 160,564.00 160,564.00 CWKS TANF Timed-Out Asst 75,498.00 75,498.00

0.00 0.00 0.00 KinGAP Asst 21,621.00 21,621.00 CWKS Recent Non-Citizens Mixed Cases 1,448.00 1,448.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal (300.00) (300.00)EBT FS GA/GR (1,198.48) (1,198.48)Fraud Recovery Incentive 56,982.00 56,982.00 ARC 1,742.00 1,742.00

0.00 0.00 TOTAL REMITTANCE 389,626.00 21,621.00 411,247.00 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SierraSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 835.00 5,041.00 5,876.00 CWKS Safety Net Asst SEP-16 MO 500.00 500.00 CWKS TANF Timed-Out Asst 0.00 0.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 835.00 5,541.00 6,376.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 1,515.00 5,907.00 7,422.00 CWKS Safety Net Asst JUN-16 MO 518.00 518.00 CWKS TANF Timed-Out Asst 0.00 0.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (2,004.00) (5,907.00) (7,911.00)CWKS Safety Net Asst JUN-16 MO (500.00) (500.00)CWKS TANF Timed-Out Asst JUN-16 MO (400.00) (400.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO (489.00) 0.00 (489.00)CWKS Safety Net Asst JUN-16 MO 18.00 18.00 CWKS TANF Timed-Out Asst (400.00) (400.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments (489.00) (382.00) (871.00)

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment (489.00) (382.00) (871.00)MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. 0.00 0.00 CWKS Monthly MOE Subaccount Act. 0.00 0.00 CWKS Monthly MOE Subaccount Est. 0.00 0.00 Family Support Subaccount 0.00 0.00 Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth 0.00 0.00 Child Poverty Subaccount Expenditure JUN-16 MO 835.00 835.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (14.64) (14.64)0.00 0.00

Total Miscellaneous Adjustment 0.00 820.36 820.36

TOTAL 346.00 5,979.36 6,325.36 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SierraSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00

Total Advances 0.00 0.00 0.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00 Less: Advances 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00 Net AdjustmentsFedGAP Asst 0.00 0.00 KinGAP Asst 0.00 0.00 Total Net Adjustments 0.00 0.00 0.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 0.00 0.00 0.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 0.00 0.00 0.00

AS SHOWN ON REMITTANCE ADVICES0.00 0.00

CALWORKS Asst 346.00 5,876.00 6,222.00 CWKS Safety Net Asst 518.00 518.00 CWKS TANF Timed-Out Asst (400.00) (400.00)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

EBT FS GA/GR (14.64) (14.64)0.00 0.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 346.00 5,979.36 6,325.36 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SiskiyouSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 50,911.00 152,123.00 203,034.00 CWKS Safety Net Asst SEP-16 MO 41,600.00 41,600.00 CWKS TANF Timed-Out Asst SEP-16 MO 26,500.00 26,500.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 600.00 600.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 50,911.00 220,823.00 271,734.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 53,343.00 172,148.00 225,491.00 CWKS Safety Net Asst JUN-16 MO 46,392.00 46,392.00 CWKS TANF Timed-Out Asst JUN-16 MO 29,583.00 29,583.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,164.00 1,164.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (58,400.00) (172,148.00) (230,548.00)CWKS Safety Net Asst JUN-16 MO (41,900.00) (41,900.00)CWKS TANF Timed-Out Asst JUN-16 MO (32,000.00) (32,000.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,100.00) (1,100.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO (5,057.00) 0.00 (5,057.00)CWKS Safety Net Asst JUN-16 MO 4,492.00 4,492.00 CWKS TANF Timed-Out Asst JUN-16 MO (2,417.00) (2,417.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 64.00 64.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments (5,057.00) 2,139.00 (2,918.00)

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment (5,057.00) 2,139.00 (2,918.00)MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (143,206.00) (143,206.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (119,068.85) (119,068.85)CWKS Monthly MOE Subaccount Est. JUN-16 MO 125,531.00 125,531.00 Family Support Subaccount JUL-16 MO (43,082.52) (43,082.52)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (21,261.25) (21,261.25)Child Poverty Subaccount Expenditure JUN-16 MO 32,315.00 32,315.00 Child Poverty Subaccount Recoup** JUN-16 MO (21,743.71) (21,743.71)Child Poverty Growth FY14-15** FY 2015-16 (3,128.69) (3,128.69)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (303.74) (303.74)0.00 0.00

Total Miscellaneous Adjustment 0.00 (193,948.76) (193,948.76)

TOTAL 45,854.00 29,013.24 74,867.24 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SiskiyouSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 5,600.00 5,600.00 KinGAP Asst SEP-16 MO 3,400.00 3,400.00

Total Advances 5,600.00 3,400.00 9,000.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 6,109.00 6,109.00 KinGAP Asst JUN-16 MO 3,812.00 3,812.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (5,500.00) (5,500.00)KinGAP Asst JUN-16 MO (3,300.00) (3,300.00)Net AdjustmentsFedGAP Asst JUN-16 MO 609.00 609.00 KinGAP Asst JUN-16 MO 512.00 512.00 Total Net Adjustments 609.00 512.00 1,121.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 609.00 512.00 1,121.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 679.00 679.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 679.00 679.00

TOTAL 6,209.00 4,591.00 10,800.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 6,209.00 6,209.00 CALWORKS Asst 45,854.00 (41,522.02) 4,331.98 CWKS Safety Net Asst 46,092.00 46,092.00 CWKS TANF Timed-Out Asst 24,083.00 24,083.00

0.00 0.00 0.00 KinGAP Asst 4,591.00 4,591.00 CWKS Recent Non-Citizens Mixed Cases 664.00 664.00

0.00 0.00 0.00 0.00

EBT FS GA/GR (303.74) (303.74)0.00 0.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 52,063.00 33,604.24 85,667.24 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SolanoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 462,286.00 954,613.00 1,416,899.00 CWKS Safety Net Asst SEP-16 MO 407,700.00 407,700.00 CWKS TANF Timed-Out Asst SEP-16 MO 98,200.00 98,200.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 12,600.00 12,600.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 1,300.00 1,300.00 Total Advances 462,286.00 1,474,413.00 1,936,699.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 501,735.00 1,065,679.00 1,567,414.00 CWKS Safety Net Asst JUN-16 MO 452,920.00 452,920.00 CWKS TANF Timed-Out Asst JUN-16 MO 109,781.00 109,781.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 13,197.00 13,197.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 1,402.00 1,402.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (361,526.00) (1,065,679.00) (1,427,205.00)CWKS Safety Net Asst JUN-16 MO (423,000.00) (423,000.00)CWKS TANF Timed-Out Asst JUN-16 MO (91,800.00) (91,800.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (15,600.00) (15,600.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (2,000.00) (2,000.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 140,209.00 0.00 140,209.00 CWKS Safety Net Asst JUN-16 MO 29,920.00 29,920.00 CWKS TANF Timed-Out Asst JUN-16 MO 17,981.00 17,981.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (2,403.00) (2,403.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (598.00) (598.00)Total Net Adjustments 140,209.00 44,900.00 185,109.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 140,209.00 44,900.00 185,109.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (1,084,032.00) (1,084,032.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (901,319.94) (901,319.94)CWKS Monthly MOE Subaccount Est. JUN-16 MO 950,233.00 950,233.00 Family Support Subaccount JUL-16 MO (326,123.38) (326,123.38)Family Support Subaccount - Recoupment* APR-15 MO (10,000.00) (10,000.00)Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (160,942.06) (160,942.06)Child Poverty Subaccount Expenditure JUN-16 MO 228,415.00 228,415.00 Child Poverty Subaccount Recoup** JUN-16 MO (164,594.21) (164,594.21)Child Poverty Growth FY14-15** FY 2015-16 (63,820.79) (63,820.79)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 12,486.00 0.00 12,486.00 0.00 0.00

ARC Exp. JUN-16 MO 16,923.00 16,923.00 EBT FS GA/GR APR-16 MO (2,411.53) (2,411.53)

0.00 0.00 Total Miscellaneous Adjustment 12,486.00 (1,517,672.91) (1,505,186.91)

TOTAL 614,981.00 1,640.09 616,621.09 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SolanoSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 16,300.00 16,300.00 KinGAP Asst SEP-16 MO 4,700.00 4,700.00

Total Advances 16,300.00 4,700.00 21,000.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 17,787.00 17,787.00 KinGAP Asst JUN-16 MO 6,366.00 6,366.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (15,800.00) (15,800.00)KinGAP Asst JUN-16 MO (4,400.00) (4,400.00)Net AdjustmentsFedGAP Asst JUN-16 MO 1,987.00 1,987.00 KinGAP Asst JUN-16 MO 1,966.00 1,966.00 Total Net Adjustments 1,987.00 1,966.00 3,953.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,987.00 1,966.00 3,953.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 859.00 679.00 1,538.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 859.00 679.00 1,538.00

TOTAL 19,146.00 7,345.00 26,491.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 19,146.00 19,146.00 CALWORKS Asst 614,981.00 (577,571.38) 37,409.62 CWKS Safety Net Asst 437,620.00 437,620.00 CWKS TANF Timed-Out Asst 116,181.00 116,181.00

0.00 0.00 0.00 KinGAP Asst 7,345.00 7,345.00 CWKS Recent Non-Citizens Mixed Cases 10,197.00 10,197.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 702.00 702.00 EBT FS GA/GR (2,411.53) (2,411.53)

0.00 0.00 ARC 16,923.00 16,923.00

0.00 0.00 TOTAL REMITTANCE 634,127.00 8,985.09 643,112.09 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SonomaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 184,452.00 507,702.00 692,154.00 CWKS Safety Net Asst SEP-16 MO 76,500.00 76,500.00 CWKS TANF Timed-Out Asst SEP-16 MO 97,700.00 97,700.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 24,700.00 24,700.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 2,700.00 2,700.00 Total Advances 184,452.00 709,302.00 893,754.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 233,755.00 546,693.00 780,448.00 CWKS Safety Net Asst JUN-16 MO 85,248.00 85,248.00 CWKS TANF Timed-Out Asst JUN-16 MO 109,118.00 109,118.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 27,532.00 27,532.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 3,051.00 3,051.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (185,463.00) (546,693.00) (732,156.00)CWKS Safety Net Asst JUN-16 MO (80,600.00) (80,600.00)CWKS TANF Timed-Out Asst JUN-16 MO (98,000.00) (98,000.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (25,400.00) (25,400.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (2,700.00) (2,700.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 48,292.00 0.00 48,292.00 CWKS Safety Net Asst JUN-16 MO 4,648.00 4,648.00 CWKS TANF Timed-Out Asst JUN-16 MO 11,118.00 11,118.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 2,132.00 2,132.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 351.00 351.00 Total Net Adjustments 48,292.00 18,249.00 66,541.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 48,292.00 18,249.00 66,541.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (539,586.00) (539,586.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (448,639.84) (448,639.84)CWKS Monthly MOE Subaccount Est. JUN-16 MO 472,987.00 472,987.00 Family Support Subaccount JUL-16 MO (162,330.75) (162,330.75)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 30,346.29 30,346.29 Family Support Subaccount FY14-15 Growth FY 2014-15 (80,110.31) (80,110.31)Child Poverty Subaccount Expenditure JUN-16 MO 109,884.00 109,884.00 Child Poverty Subaccount Recoup** JUN-16 MO (81,928.20) (81,928.20)Child Poverty Growth FY14-15** FY 2015-16 (27,955.80) (27,955.80)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 1,026.00 1,026.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 16,823.00 0.00 16,823.00 CWKs ARC (NON-MOE) JUN-16 MO 666.00 666.00 ARC Exp. JUN-16 MO 19,972.00 19,972.00 ARC Exp. Deferred*** JUN-16 MO (19,972.00) (19,972.00)EBT FS GA/GR APR-16 MO (1,909.39) (1,909.39)

0.00 0.00 Total Miscellaneous Adjustment 16,823.00 (727,551.00) (710,728.00)

TOTAL 249,567.00 0.00 249,567.00 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SonomaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 17,400.00 17,400.00 KinGAP Asst SEP-16 MO 14,600.00 14,600.00

Total Advances 17,400.00 14,600.00 32,000.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 18,970.00 18,970.00 KinGAP Asst JUN-16 MO 16,351.00 16,351.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (18,200.00) (18,200.00)KinGAP Asst JUN-16 MO (14,700.00) (14,700.00)Net AdjustmentsFedGAP Asst JUN-16 MO 770.00 770.00 KinGAP Asst JUN-16 MO 1,651.00 1,651.00 Total Net Adjustments 770.00 1,651.00 2,421.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 770.00 1,651.00 2,421.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 679.00 679.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 679.00 679.00

TOTAL 18,170.00 16,930.00 35,100.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 18,170.00 18,170.00 CALWORKS Asst 249,567.00 (218,965.61) 30,601.39 CWKS Safety Net Asst 81,148.00 81,148.00 CWKS TANF Timed-Out Asst 108,818.00 108,818.00

0.00 0.00 0.00 KinGAP Asst 16,930.00 16,930.00 CWKS Recent Non-Citizens Mixed Cases 26,832.00 26,832.00 CWKS Recent Non-Citizens TANF Timed-Out 1,026.00 1,026.00 CWKS Recent Non-Citizens NonFederal 3,051.00 3,051.00 EBT FS GA/GR (1,909.39) (1,909.39)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 267,737.00 16,930.00 284,667.00 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: StanislausSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 870,315.00 1,926,115.00 2,796,430.00 CWKS Safety Net Asst SEP-16 MO 647,600.00 647,600.00 CWKS TANF Timed-Out Asst SEP-16 MO 378,200.00 378,200.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 14,200.00 14,200.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 1,500.00 1,500.00 Total Advances 870,315.00 2,967,615.00 3,837,930.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 940,494.00 2,196,713.00 3,137,207.00 CWKS Safety Net Asst JUN-16 MO 720,905.00 720,905.00 CWKS TANF Timed-Out Asst JUN-16 MO 422,578.00 422,578.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 15,841.00 15,841.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 1,473.00 1,473.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (745,223.00) (2,196,713.00) (2,941,936.00)CWKS Safety Net Asst JUN-16 MO (645,700.00) (645,700.00)CWKS TANF Timed-Out Asst JUN-16 MO (381,600.00) (381,600.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (13,400.00) (13,400.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (1,800.00) (1,800.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 195,271.00 0.00 195,271.00 CWKS Safety Net Asst JUN-16 MO 75,205.00 75,205.00 CWKS TANF Timed-Out Asst JUN-16 MO 40,978.00 40,978.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 2,441.00 2,441.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO (327.00) (327.00)Total Net Adjustments 195,271.00 118,297.00 313,568.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 195,271.00 118,297.00 313,568.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (2,117,445.00) (2,117,445.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (1,760,553.03) (1,760,553.03)CWKS Monthly MOE Subaccount Est. JUN-16 MO 1,856,096.00 1,856,096.00 Family Support Subaccount JUL-16 MO (637,018.52) (637,018.52)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (314,368.97) (314,368.97)Child Poverty Subaccount Expenditure JUN-16 MO 456,142.00 456,142.00 Child Poverty Subaccount Recoup** JUN-16 MO (321,502.71) (321,502.71)Child Poverty Growth FY14-15** FY 2015-16 (134,639.29) (134,639.29)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 12,549.00 0.00 12,549.00 0.00 0.00

ARC Exp. JUN-16 MO 15,713.00 15,713.00 ARC Exp. Deferred*** JUN-16 MO (15,713.00) (15,713.00)EBT FS GA/GR APR-16 MO (3,904.08) (3,904.08)

0.00 0.00 Total Miscellaneous Adjustment 12,549.00 (2,977,193.60) (2,964,644.60)

TOTAL 1,078,135.00 108,718.40 1,186,853.40 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: StanislausSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 10,700.00 10,700.00 KinGAP Asst SEP-16 MO 14,500.00 14,500.00

Total Advances 10,700.00 14,500.00 25,200.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 11,708.00 11,708.00 KinGAP Asst JUN-16 MO 16,175.00 16,175.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (12,100.00) (12,100.00)KinGAP Asst JUN-16 MO (11,900.00) (11,900.00)Net AdjustmentsFedGAP Asst JUN-16 MO (392.00) (392.00)KinGAP Asst JUN-16 MO 4,275.00 4,275.00 Total Net Adjustments (392.00) 4,275.00 3,883.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment (392.00) 4,275.00 3,883.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 10,308.00 18,775.00 29,083.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 10,308.00 10,308.00 CALWORKS Asst 1,078,135.00 (1,047,174.52) 30,960.48 CWKS Safety Net Asst 722,805.00 722,805.00 CWKS TANF Timed-Out Asst 419,178.00 419,178.00

0.00 0.00 0.00 KinGAP Asst 18,775.00 18,775.00 CWKS Recent Non-Citizens Mixed Cases 16,641.00 16,641.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 1,173.00 1,173.00 EBT FS GA/GR (3,904.08) (3,904.08)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 1,088,443.00 127,493.40 1,215,936.40 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SutterSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 138,127.00 288,718.00 426,845.00 CWKS Safety Net Asst SEP-16 MO 106,100.00 106,100.00 CWKS TANF Timed-Out Asst SEP-16 MO 37,500.00 37,500.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 7,000.00 7,000.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 2,500.00 2,500.00 Total Advances 138,127.00 441,818.00 579,945.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 146,869.00 330,259.00 477,128.00 CWKS Safety Net Asst JUN-16 MO 118,284.00 118,284.00 CWKS TANF Timed-Out Asst JUN-16 MO 41,902.00 41,902.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 7,779.00 7,779.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,731.00 2,731.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (112,039.00) (330,259.00) (442,298.00)CWKS Safety Net Asst JUN-16 MO (111,100.00) (111,100.00)CWKS TANF Timed-Out Asst JUN-16 MO (36,100.00) (36,100.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (8,000.00) (8,000.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (2,000.00) (2,000.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 34,830.00 0.00 34,830.00 CWKS Safety Net Asst JUN-16 MO 7,184.00 7,184.00 CWKS TANF Timed-Out Asst JUN-16 MO 5,802.00 5,802.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (221.00) (221.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 731.00 731.00 Total Net Adjustments 34,830.00 13,496.00 48,326.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 34,830.00 13,496.00 48,326.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (284,766.00) (284,766.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (236,768.90) (236,768.90)CWKS Monthly MOE Subaccount Est. JUN-16 MO 249,618.00 249,618.00 Family Support Subaccount JUL-16 MO (85,669.77) (85,669.77)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (42,278.08) (42,278.08)Child Poverty Subaccount Expenditure JUN-16 MO 68,386.00 68,386.00 Child Poverty Subaccount Recoup** JUN-16 MO (43,237.47) (43,237.47)Child Poverty Growth FY14-15** FY 2015-16 (11,726.21) (11,726.21)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (539.23) (539.23)0.00 0.00

Total Miscellaneous Adjustment 0.00 (386,981.66) (386,981.66)

TOTAL 172,957.00 68,332.34 241,289.34 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: SutterSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 1,000.00 1,000.00 KinGAP Asst SEP-16 MO 1,700.00 1,700.00

Total Advances 1,000.00 1,700.00 2,700.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 1,088.00 1,088.00 KinGAP Asst JUN-16 MO 1,941.00 1,941.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (1,000.00) (1,000.00)KinGAP Asst JUN-16 MO (1,700.00) (1,700.00)Net AdjustmentsFedGAP Asst JUN-16 MO 88.00 88.00 KinGAP Asst JUN-16 MO 241.00 241.00 Total Net Adjustments 88.00 241.00 329.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 88.00 241.00 329.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 1,088.00 1,941.00 3,029.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 1,088.00 1,088.00 CALWORKS Asst 172,957.00 (97,724.43) 75,232.57 CWKS Safety Net Asst 113,284.00 113,284.00 CWKS TANF Timed-Out Asst 43,302.00 43,302.00

0.00 0.00 0.00 KinGAP Asst 1,941.00 1,941.00 CWKS Recent Non-Citizens Mixed Cases 6,779.00 6,779.00

0.00 0.00 CWKS Recent Non-Citizens NonFederal 3,231.00 3,231.00 EBT FS GA/GR (539.23) (539.23)

0.00 0.00 0.00 0.00 0.00 0.00

TOTAL REMITTANCE 174,045.00 70,273.34 244,318.34 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: TehamaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 99,044.00 230,209.00 329,253.00 CWKS Safety Net Asst SEP-16 MO 54,500.00 54,500.00 CWKS TANF Timed-Out Asst SEP-16 MO 40,100.00 40,100.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 1,700.00 1,700.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 1,700.00 1,700.00 Total Advances 99,044.00 328,209.00 427,253.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 114,817.00 255,099.00 369,916.00 CWKS Safety Net Asst JUN-16 MO 60,823.00 60,823.00 CWKS TANF Timed-Out Asst JUN-16 MO 44,849.00 44,849.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,916.00 1,916.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 1,844.00 1,844.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (86,541.00) (255,099.00) (341,640.00)CWKS Safety Net Asst JUN-16 MO (52,400.00) (52,400.00)CWKS TANF Timed-Out Asst JUN-16 MO (37,200.00) (37,200.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,400.00) (1,400.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (1,600.00) (1,600.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 28,276.00 0.00 28,276.00 CWKS Safety Net Asst JUN-16 MO 8,423.00 8,423.00 CWKS TANF Timed-Out Asst JUN-16 MO 7,649.00 7,649.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 516.00 516.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 244.00 244.00 Total Net Adjustments 28,276.00 16,832.00 45,108.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 28,276.00 16,832.00 45,108.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (245,454.00) (245,454.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (204,083.02) (204,083.02)CWKS Monthly MOE Subaccount Est. JUN-16 MO 215,158.00 215,158.00 Family Support Subaccount JUL-16 MO (73,843.08) (73,843.08)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (36,441.60) (36,441.60)Child Poverty Subaccount Expenditure JUN-16 MO 50,618.00 50,618.00 Child Poverty Subaccount Recoup** JUN-16 MO (37,268.56) (37,268.56)Child Poverty Growth FY14-15** FY 2015-16 (13,349.44) (13,349.44)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 1,289.00 0.00 1,289.00 0.00 0.00

ARC Exp. JUN-16 MO 1,629.00 1,629.00 EBT FS GA/GR APR-16 MO (431.99) (431.99)

0.00 0.00 Total Miscellaneous Adjustment 1,289.00 (343,466.69) (342,177.69)

TOTAL 128,609.00 1,574.31 130,183.31 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: TehamaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst 0.00 0.00 KinGAP Asst SEP-16 MO 500.00 500.00

Total Advances 0.00 500.00 500.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO 588.00 588.00 Less: Advances 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO (500.00) (500.00)Net AdjustmentsFedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO 88.00 88.00 Total Net Adjustments 0.00 88.00 88.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 0.00 88.00 88.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 0.00 588.00 588.00

AS SHOWN ON REMITTANCE ADVICES0.00 0.00

CALWORKS Asst 128,609.00 (114,454.70) 14,154.30 CWKS Safety Net Asst 62,923.00 62,923.00 CWKS TANF Timed-Out Asst 47,749.00 47,749.00

0.00 0.00 0.00 KinGAP Asst 588.00 588.00 CWKS Recent Non-Citizens Mixed Cases 2,216.00 2,216.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 1,944.00 1,944.00 EBT FS GA/GR (431.99) (431.99)

0.00 0.00 ARC 1,629.00 1,629.00

0.00 0.00 TOTAL REMITTANCE 128,609.00 2,162.31 130,771.31 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: TrinitySHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 5,879.00 24,404.00 30,283.00 CWKS Safety Net Asst SEP-16 MO 5,700.00 5,700.00 CWKS TANF Timed-Out Asst SEP-16 MO 2,900.00 2,900.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 5,879.00 33,004.00 38,883.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 10,312.00 27,090.00 37,402.00 CWKS Safety Net Asst JUN-16 MO 6,354.00 6,354.00 CWKS TANF Timed-Out Asst JUN-16 MO 3,266.00 3,266.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (9,190.00) (27,090.00) (36,280.00)CWKS Safety Net Asst JUN-16 MO (4,500.00) (4,500.00)CWKS TANF Timed-Out Asst JUN-16 MO (2,700.00) (2,700.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 1,122.00 0.00 1,122.00 CWKS Safety Net Asst JUN-16 MO 1,854.00 1,854.00 CWKS TANF Timed-Out Asst JUN-16 MO 566.00 566.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 1,122.00 2,420.00 3,542.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,122.00 2,420.00 3,542.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. 0.00 0.00 CWKS Monthly MOE Subaccount Act. 0.00 0.00 CWKS Monthly MOE Subaccount Est. 0.00 0.00 Family Support Subaccount 0.00 0.00 Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth 0.00 0.00 Child Poverty Subaccount Expenditure JUN-16 MO 5,024.00 5,024.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 ARC Exp. JUN-16 MO 1,488.00 1,488.00 EBT FS GA/GR APR-16 MO (93.56) (93.56)

0.00 0.00 Total Miscellaneous Adjustment 0.00 6,418.44 6,418.44

TOTAL 7,001.00 41,842.44 48,843.44 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: TrinitySHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst 0.00 0.00 KinGAP Asst SEP-16 MO 600.00 600.00

Total Advances 0.00 600.00 600.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO 616.00 616.00 Less: Advances 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO (600.00) (600.00)Net AdjustmentsFedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO 16.00 16.00 Total Net Adjustments 0.00 16.00 16.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 0.00 16.00 16.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus 0.00 679.00 679.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 0.00 679.00 679.00

TOTAL 0.00 1,295.00 1,295.00

AS SHOWN ON REMITTANCE ADVICES0.00 0.00

CALWORKS Asst 7,001.00 29,428.00 36,429.00 CWKS Safety Net Asst 7,554.00 7,554.00 CWKS TANF Timed-Out Asst 3,466.00 3,466.00

0.00 0.00 0.00 KinGAP Asst 1,295.00 1,295.00

0.00 0.00 0.00 0.00 0.00 0.00

EBT FS GA/GR (93.56) (93.56)0.00 0.00

ARC 1,488.00 1,488.00 0.00 0.00

TOTAL REMITTANCE 7,001.00 43,137.44 50,138.44 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: TulareSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 1,255,766.00 2,718,392.00 3,974,158.00 CWKS Safety Net Asst SEP-16 MO 998,900.00 998,900.00 CWKS TANF Timed-Out Asst SEP-16 MO 369,400.00 369,400.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 37,800.00 37,800.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 8,200.00 8,200.00 Total Advances 1,255,766.00 4,132,692.00 5,388,458.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 1,261,193.00 3,146,552.00 4,407,745.00 CWKS Safety Net Asst JUN-16 MO 1,111,808.00 1,111,808.00 CWKS TANF Timed-Out Asst JUN-16 MO 412,804.00 412,804.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 42,160.00 42,160.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 9,091.00 9,091.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (1,067,450.00) (3,146,552.00) (4,214,002.00)CWKS Safety Net Asst JUN-16 MO (999,300.00) (999,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (362,500.00) (362,500.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (44,300.00) (44,300.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (6,100.00) (6,100.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 193,743.00 0.00 193,743.00 CWKS Safety Net Asst JUN-16 MO 112,508.00 112,508.00 CWKS TANF Timed-Out Asst JUN-16 MO 50,304.00 50,304.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (2,140.00) (2,140.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,991.00 2,991.00 Total Net Adjustments 193,743.00 163,663.00 357,406.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 193,743.00 163,663.00 357,406.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (2,794,140.00) (2,794,140.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (2,323,192.74) (2,323,192.74)CWKS Monthly MOE Subaccount Est. JUN-16 MO 2,449,269.00 2,449,269.00 Family Support Subaccount JUL-16 MO (840,597.69) (840,597.69)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (414,835.40) (414,835.40)Child Poverty Subaccount Expenditure JUN-16 MO 640,547.00 640,547.00 Child Poverty Subaccount Recoup** JUN-16 MO (424,248.93) (424,248.93)Child Poverty Growth FY14-15** FY 2015-16 (216,298.07) (216,298.07)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 503.00 503.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 15,055.00 953.00 16,008.00

0.00 0.00 ARC Exp. JUN-16 MO (14,792.00) (14,792.00)EBT FS GA/GR APR-16 MO (4,862.53) (4,862.53)

0.00 0.00 Total Miscellaneous Adjustment 15,055.00 (3,941,695.36) (3,926,640.36)

TOTAL 1,464,564.00 354,659.64 1,819,223.64 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: TulareSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 45,800.00 45,800.00 KinGAP Asst SEP-16 MO 63,800.00 63,800.00

Total Advances 45,800.00 63,800.00 109,600.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 49,981.00 49,981.00 KinGAP Asst JUN-16 MO 71,285.00 71,285.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (44,800.00) (44,800.00)KinGAP Asst JUN-16 MO (70,300.00) (70,300.00)Net AdjustmentsFedGAP Asst JUN-16 MO 5,181.00 5,181.00 KinGAP Asst JUN-16 MO 985.00 985.00 Total Net Adjustments 5,181.00 985.00 6,166.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 5,181.00 985.00 6,166.00

MISC. ADJUSTMENT0.00 0.00

KinGAP 18 Plus JUN-16 MO 1,270.00 3,578.00 4,848.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment 1,270.00 3,578.00 4,848.00

TOTAL 52,251.00 68,363.00 120,614.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 52,251.00 52,251.00 CALWORKS Asst 1,464,564.00 (1,204,151.83) 260,412.17 CWKS Safety Net Asst 1,111,408.00 1,111,408.00 CWKS TANF Timed-Out Asst 419,704.00 419,704.00

0.00 0.00 0.00 KinGAP Asst 68,363.00 68,363.00 CWKS Recent Non-Citizens Mixed Cases 35,660.00 35,660.00 CWKS Recent Non-Citizens TANF Timed-Out 503.00 503.00 CWKS Recent Non-Citizens NonFederal 11,191.00 11,191.00 EBT FS GA/GR (4,862.53) (4,862.53)

0.00 0.00 ARC (14,792.00) (14,792.00)

0.00 0.00 TOTAL REMITTANCE 1,516,815.00 423,022.64 1,939,837.64 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: TuolumneSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 32,761.00 113,385.00 146,146.00 CWKS Safety Net Asst SEP-16 MO 19,300.00 19,300.00 CWKS TANF Timed-Out Asst SEP-16 MO 17,100.00 17,100.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Advances 32,761.00 149,785.00 182,546.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 45,265.00 119,724.00 164,989.00 CWKS Safety Net Asst JUN-16 MO 21,476.00 21,476.00 CWKS TANF Timed-Out Asst JUN-16 MO 19,103.00 19,103.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (40,616.00) (119,724.00) (160,340.00)CWKS Safety Net Asst JUN-16 MO (17,300.00) (17,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (17,100.00) (17,100.00)CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 0.00 0.00 Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 4,649.00 0.00 4,649.00 CWKS Safety Net Asst JUN-16 MO 4,176.00 4,176.00 CWKS TANF Timed-Out Asst JUN-16 MO 2,003.00 2,003.00 CWKS Recent Non-Citizens Mixed Cases 0.00 0.00 CWKS Recent Non-Citizens Nonfederal 0.00 0.00 Total Net Adjustments 4,649.00 6,179.00 10,828.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 4,649.00 6,179.00 10,828.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (116,692.00) (116,692.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (97,023.84) (97,023.84)CWKS Monthly MOE Subaccount Est. JUN-16 MO 102,289.00 102,289.00 Family Support Subaccount JUL-16 MO (35,106.00) (35,106.00)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* JUL-16 MO 8,186.01 8,186.01 Family Support Subaccount FY14-15 Growth FY 2014-15 (17,324.83) (17,324.83)Child Poverty Subaccount Expenditure JUN-16 MO 21,913.00 21,913.00 Child Poverty Subaccount Recoup** JUN-16 MO (17,717.96) (17,717.96)Child Poverty Growth FY14-15** FY 2015-16 (2,307.03) (2,307.03)

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

EBT FS GA/GR APR-16 MO (292.34) (292.34)0.00 0.00

Total Miscellaneous Adjustment 0.00 (154,075.99) (154,075.99)

TOTAL 37,410.00 1,888.01 39,298.01 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: TuolumneSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 1,400.00 1,400.00 KinGAP Asst SEP-16 MO 2,100.00 2,100.00

Total Advances 1,400.00 2,100.00 3,500.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 1,499.00 1,499.00 KinGAP Asst JUN-16 MO 2,303.00 2,303.00 Less: Advances 0.00 FedGAP Asst 0.00 0.00 KinGAP Asst JUN-16 MO (2,100.00) (2,100.00)Net AdjustmentsFedGAP Asst JUN-16 MO 1,499.00 1,499.00 KinGAP Asst JUN-16 MO 203.00 203.00 Total Net Adjustments 1,499.00 203.00 1,702.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 1,499.00 203.00 1,702.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 2,899.00 2,303.00 5,202.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 2,899.00 2,899.00 CALWORKS Asst 37,410.00 (40,398.65) (2,988.65)CWKS Safety Net Asst 23,476.00 23,476.00 CWKS TANF Timed-Out Asst 19,103.00 19,103.00

0.00 0.00 0.00 KinGAP Asst 2,303.00 2,303.00

0.00 0.00 0.00 0.00 0.00 0.00

EBT FS GA/GR (292.34) (292.34)0.00 0.00

0.00 0.00 0.00 0.00

TOTAL REMITTANCE 40,309.00 4,191.01 44,500.01 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: VenturaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 509,664.00 1,142,833.00 1,652,497.00 CWKS Safety Net Asst SEP-16 MO 223,000.00 223,000.00 CWKS TANF Timed-Out Asst SEP-16 MO 176,900.00 176,900.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 11,900.00 11,900.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 4,900.00 4,900.00 Total Advances 509,664.00 1,559,533.00 2,069,197.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 544,517.00 1,308,871.00 1,853,388.00 CWKS Safety Net Asst JUN-16 MO 248,719.00 248,719.00 CWKS TANF Timed-Out Asst JUN-16 MO 197,695.00 197,695.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 13,274.00 13,274.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 5,406.00 5,406.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (444,027.00) (1,308,871.00) (1,752,898.00)CWKS Safety Net Asst JUN-16 MO (214,300.00) (214,300.00)CWKS TANF Timed-Out Asst JUN-16 MO (172,900.00) (172,900.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (17,500.00) (17,500.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (5,200.00) (5,200.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 100,490.00 0.00 100,490.00 CWKS Safety Net Asst JUN-16 MO 34,419.00 34,419.00 CWKS TANF Timed-Out Asst JUN-16 MO 24,795.00 24,795.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (4,226.00) (4,226.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 206.00 206.00 Total Net Adjustments 100,490.00 55,194.00 155,684.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 100,490.00 55,194.00 155,684.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (1,150,730.00) (1,150,730.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (956,776.80) (956,776.80)CWKS Monthly MOE Subaccount Est. JUN-16 MO 1,008,700.00 1,008,700.00 Family Support Subaccount JUL-16 MO (346,189.25) (346,189.25)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (170,844.58) (170,844.58)Child Poverty Subaccount Expenditure JUN-16 MO 253,230.00 253,230.00 Child Poverty Subaccount Recoup** JUN-16 MO (174,721.41) (174,721.41)Child Poverty Growth FY14-15** FY 2015-16 (78,508.59) (78,508.59)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 651.00 651.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 23,614.00 0.00 23,614.00

0.00 0.00 ARC Exp. JUN-16 MO 31,149.00 31,149.00 ARC Exp. Deferred*** JUN-16 MO (24,372.00) (24,372.00)EBT FS GA/GR APR-16 MO (3,461.97) (3,461.97)

0.00 0.00 Total Miscellaneous Adjustment 23,614.00 (1,611,874.60) (1,588,260.60)

TOTAL 633,768.00 2,852.40 636,620.40 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: VenturaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 99,700.00 99,700.00 KinGAP Asst SEP-16 MO 48,200.00 48,200.00

Total Advances 99,700.00 48,200.00 147,900.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 108,749.00 108,749.00 KinGAP Asst JUN-16 MO 53,864.00 53,864.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (88,300.00) (88,300.00)KinGAP Asst JUN-16 MO (44,500.00) (44,500.00)Net AdjustmentsFedGAP Asst JUN-16 MO 20,449.00 20,449.00 KinGAP Asst JUN-16 MO 9,364.00 9,364.00 Total Net Adjustments 20,449.00 9,364.00 29,813.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 16,649.00 9,364.00 29,813.00

MISC. ADJUSTMENTFedGAP OP BEG 07/01/12 JUN-16 MO 119.00 119.00 KinGAP 18 Plus JUN-16 MO 1,112.00 4,509.00 5,621.00

0.00 0.00 0.00 0.00 0.00 0.00

FedGAP Adv MAR-16 MO (3,800.00) 0.00 (3,800.00)0.00 0.00 0.00 0.00 0.00 0.00

Total Miscellaneous Adjustment (2,569.00) 4,509.00 1,940.00

TOTAL 113,780.00 62,073.00 179,653.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 117,580.00 117,580.00 CALWORKS Asst 633,768.00 (473,007.63) 160,760.37 CWKS Safety Net Asst 257,419.00 257,419.00 CWKS TANF Timed-Out Asst 201,695.00 201,695.00

0.00 0.00 0.00 KinGAP Asst 62,073.00 62,073.00 CWKS Recent Non-Citizens Mixed Cases 7,674.00 7,674.00 CWKS Recent Non-Citizens TANF Timed-Out 651.00 651.00 CWKS Recent Non-Citizens NonFederal 5,106.00 5,106.00 EBT FS GA/GR (3,461.97) (3,461.97)

0.00 0.00 ARC 6,777.00 6,777.00

0.00 0.00 TOTAL REMITTANCE 751,348.00 64,925.40 816,273.40 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: YoloSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 140,879.00 338,205.00 479,084.00 CWKS Safety Net Asst SEP-16 MO 124,800.00 124,800.00 CWKS TANF Timed-Out Asst SEP-16 MO 42,700.00 42,700.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 15,700.00 15,700.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 13,000.00 13,000.00 Total Advances 140,879.00 534,405.00 675,284.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 148,783.00 379,475.00 528,258.00 CWKS Safety Net Asst JUN-16 MO 138,151.00 138,151.00 CWKS TANF Timed-Out Asst JUN-16 MO 47,756.00 47,756.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 17,540.00 17,540.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 14,499.00 14,499.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (128,735.00) (379,475.00) (508,210.00)CWKS Safety Net Asst JUN-16 MO (123,200.00) (123,200.00)CWKS TANF Timed-Out Asst JUN-16 MO (52,000.00) (52,000.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (20,900.00) (20,900.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (15,800.00) (15,800.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 20,048.00 0.00 20,048.00 CWKS Safety Net Asst JUN-16 MO 14,951.00 14,951.00 CWKS TANF Timed-Out Asst JUN-16 MO (4,244.00) (4,244.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (3,360.00) (3,360.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (1,301.00) (1,301.00)Total Net Adjustments 20,048.00 6,046.00 26,094.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 20,048.00 6,046.00 26,094.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (332,502.00) (332,502.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (276,459.08) (276,459.08)CWKS Monthly MOE Subaccount Est. JUN-16 MO 291,462.00 291,462.00 Family Support Subaccount JUL-16 MO (100,030.82) (100,030.82)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (49,365.26) (49,365.26)Child Poverty Subaccount Expenditure JUN-16 MO 79,194.00 79,194.00 Child Poverty Subaccount Recoup** JUN-16 MO (50,485.46) (50,485.46)

0.00 0.00 CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 577.00 577.00

0.00 0.00 0.00 CWKs ARC (MOE) JUN-16 MO 3,900.00 0.00 3,900.00

0.00 0.00 ARC Exp. JUN-16 MO 3,676.00 3,676.00 EBT FS GA/GR APR-16 MO (989.95) (989.95)

0.00 0.00 Total Miscellaneous Adjustment 3,900.00 (434,923.57) (431,023.57)

TOTAL 164,827.00 105,527.43 270,354.43 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: YoloSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 4,100.00 4,100.00 KinGAP Asst SEP-16 MO 1,400.00 1,400.00

Total Advances 4,100.00 1,400.00 5,500.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 4,487.00 4,487.00 KinGAP Asst JUN-16 MO 1,558.00 1,558.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (4,000.00) (4,000.00)KinGAP Asst JUN-16 MO (1,400.00) (1,400.00)Net AdjustmentsFedGAP Asst JUN-16 MO 487.00 487.00 KinGAP Asst JUN-16 MO 158.00 158.00 Total Net Adjustments 487.00 158.00 645.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 487.00 158.00 645.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00

Fraud Recovery Incentive JUN-16 QTR 12,622.00 12,622.00 Total Miscellaneous Adjustment 12,622.00 0.00 12,622.00

TOTAL 17,209.00 1,558.00 18,767.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 4,587.00 4,587.00 CALWORKS Asst 164,827.00 (99,981.62) 64,845.38 CWKS Safety Net Asst 139,751.00 139,751.00 CWKS TANF Timed-Out Asst 38,456.00 38,456.00

0.00 0.00 0.00 KinGAP Asst 1,558.00 1,558.00 CWKS Recent Non-Citizens Mixed Cases 12,340.00 12,340.00 CWKS Recent Non-Citizens TANF Timed-Out 577.00 577.00 CWKS Recent Non-Citizens NonFederal 11,699.00 11,699.00 EBT FS GA/GR (989.95) (989.95)Fraud Recovery Incentive 12,622.00 12,622.00 ARC 3,676.00 3,676.00

0.00 0.00 TOTAL REMITTANCE 182,036.00 107,085.43 289,121.43 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: YubaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 123,391.00 283,716.00 407,107.00 CWKS Safety Net Asst SEP-16 MO 127,400.00 127,400.00 CWKS TANF Timed-Out Asst SEP-16 MO 53,400.00 53,400.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 1,800.00 1,800.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 2,300.00 2,300.00 Total Advances 123,391.00 468,616.00 592,007.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 136,007.00 321,913.00 457,920.00 CWKS Safety Net Asst JUN-16 MO 142,013.00 142,013.00 CWKS TANF Timed-Out Asst JUN-16 MO 59,655.00 59,655.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 1,974.00 1,974.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 2,533.00 2,533.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (109,207.00) (321,913.00) (431,120.00)CWKS Safety Net Asst JUN-16 MO (119,600.00) (119,600.00)CWKS TANF Timed-Out Asst JUN-16 MO (60,100.00) (60,100.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (1,200.00) (1,200.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (1,500.00) (1,500.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 26,800.00 0.00 26,800.00 CWKS Safety Net Asst JUN-16 MO 22,413.00 22,413.00 CWKS TANF Timed-Out Asst JUN-16 MO (445.00) (445.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 774.00 774.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 1,033.00 1,033.00 Total Net Adjustments 26,800.00 23,775.00 50,575.00

Calworks - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 26,800.00 23,775.00 50,575.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (325,663.00) (325,663.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (270,772.70) (270,772.70)CWKS Monthly MOE Subaccount Est. JUN-16 MO 285,467.00 285,467.00 Family Support Subaccount JUL-16 MO (97,973.32) (97,973.32)Family Support Subaccount - Recoupment* 0.00 0.00 Family Support Subaccount - Deferment* 0.00 0.00 Family Support Subaccount FY14-15 Growth (48,349.88) (48,349.88)Child Poverty Subaccount Expenditure JUN-16 MO 70,280.00 70,280.00 Child Poverty Subaccount Recoup** JUN-16 MO (49,447.06) (49,447.06)Child Poverty Growth FY14-15** FY 2015-16 (20,832.94) (20,832.94)

0.00 0.00 0.00 0.00 0.00

CWKs ARC (MOE) JUN-16 MO 2,936.00 0.00 2,936.00 0.00 0.00

ARC Exp. JUN-16 MO 8,611.00 8,611.00 ARC Exp. Deferred*** JUN-16 MO (2,086.00) (2,086.00)EBT FS GA/GR APR-16 MO (577.44) (577.44)

0.00 0.00 Total Miscellaneous Adjustment 2,936.00 (451,344.34) (448,408.34)

TOTAL 153,127.00 41,046.66 194,173.66 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: YubaSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 700.00 700.00 KinGAP Asst SEP-16 MO 1,000.00 1,000.00

Total Advances 700.00 1,000.00 1,700.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 744.00 744.00 KinGAP Asst JUN-16 MO 1,094.00 1,094.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (700.00) (700.00)KinGAP Asst JUN-16 MO (300.00) (300.00)Net AdjustmentsFedGAP Asst JUN-16 MO 44.00 44.00 KinGAP Asst JUN-16 MO 794.00 794.00 Total Net Adjustments 44.00 794.00 838.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 44.00 794.00 838.00

MISC. ADJUSTMENT0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

TOTAL 744.00 1,794.00 2,538.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 744.00 744.00 CALWORKS Asst 153,127.00 (173,575.90) (20,448.90)CWKS Safety Net Asst 149,813.00 149,813.00 CWKS TANF Timed-Out Asst 52,955.00 52,955.00

0.00 0.00 0.00 KinGAP Asst 1,794.00 1,794.00 CWKS Recent Non-Citizens Mixed Cases 2,574.00 2,574.00 CWKS Recent Non-Citizens TANF Timed-Out 0.00 0.00 CWKS Recent Non-Citizens NonFederal 3,333.00 3,333.00 EBT FS GA/GR (577.44) (577.44)

0.00 0.00 ARC 6,525.00 6,525.00

0.00 0.00 TOTAL REMITTANCE 153,871.00 42,840.66 196,711.66 Sch No. 020527TCOMMENTS:

STATEMENT OF CASH ADVANCE - AA190STATE OF CALIFORNIA

HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ControlSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALCALWORKS ASST, CALWORKS RECENT NON-CITIZENS MIXED CASES,

NONFEDERAL & TANF TIMED OUTADVANCES (100%) (CFDA #93.558) 0.00 CalWORKS Asst SEP-16 MO 46,000,000.00 95,000,000.00 141,000,000.00 CWKS Safety Net Asst SEP-16 MO 31,000,000.00 31,000,000.00 CWKS TANF Timed-Out Asst SEP-16 MO 13,000,000.00 13,000,000.00 CWKS Recent Non-Citizens Mixed Cases SEP-16 MO 3,100,000.00 3,100,000.00 CWKS Recent Non-Citizens Nonfederal SEP-16 MO 1,100,000.00 1,100,000.00 Total Advances 46,000,000.00 143,200,000.00 189,200,000.00

ADJUSTMENT FOR PRIOR PERIOD:Actual ExpendituresCalWORKS Asst JUN-16 MO 47,997,852.00 108,205,000.00 156,202,852.00 CWKS Safety Net Asst JUN-16 MO 34,461,244.00 34,461,244.00 CWKS TANF Timed-Out Asst JUN-16 MO 14,537,819.00 14,537,819.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO 3,461,270.00 3,461,270.00 CWKS Recent Non-Citizens Nonfederal JUN-16 MO 1,226,367.00 1,226,367.00 Less: Advances 0.00 CalWORKS Asst JUN-16 MO (36,730,000.00) (108,270,000.00) (145,000,000.00)CWKS Safety Net Asst JUN-16 MO (31,000,000.00) (31,000,000.00)CWKS TANF Timed-Out Asst JUN-16 MO (13,000,000.00) (13,000,000.00)CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (3,600,000.00) (3,600,000.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO (1,150,000.00) (1,150,000.00)Net Adjustments 0.00 CalWORKS Asst JUN-16 MO 11,267,852.00 (65,000.00) 11,202,852.00 CWKS Safety Net Asst JUN-16 MO 3,461,244.00 3,461,244.00 CWKS TANF Timed-Out Asst JUN-16 MO 1,537,819.00 1,537,819.00 CWKS Recent Non-Citizens Mixed Cases JUN-16 MO (138,730.00) (138,730.00)CWKS Recent Non-Citizens Nonfederal JUN-16 MO 76,367.00 76,367.00 Total Net Adjustments 11,267,852.00 4,871,700.00 16,139,552.00

Calworks - Deferred Recoupment JUN-16 MO 441,997.00 441,997.00 Total Prior Period Adjustment 11,709,849.00 4,871,700.00 16,581,549.00 MISC. ADJUSTMENT

CWKS Monthly MOE Subaccount Est. SEP-16 MO (102,000,000.00) (102,000,000.00)CWKS Monthly MOE Subaccount Act. JUN-16 MO (84,808,082.07) (84,808,082.07)CWKS Monthly MOE Subaccount Est. JUN-16 MO 89,410,500.00 89,410,500.00 Family Support Subaccount JUL-16 MO (30,685,993.61) (30,685,993.61)Family Support Subaccount - Recoupment* APR-15 MO (235,572.97) (235,572.97)Family Support Subaccount - Deferment* JUL-16 MO 1,050,610.62 1,050,610.62 Family Support Subaccount FY14-15 Growth FY 2014-15 (15,143,553.81) (15,143,553.81)Child Poverty Subaccount Expenditure JUN-16 MO 22,782,219.00 22,782,219.00 Child Poverty Subaccount Recoup** JUN-16 MO (15,487,195.00) (15,487,195.00)Child Poverty Growth FY14-15** FY 2015-16 (6,547,667.18) (6,547,667.18)CWKS Recent Non-Citizens TANF Timed-Out Exp JUN-16 MO 62,854.00 62,854.00 CWKS Diversion Asst JUN-16 MO 38,832.00 3,256.00 42,088.00 CWKs ARC (MOE) JUN-16 MO 1,269,065.00 1,903.00 1,270,968.00 CWKs ARC (NON-MOE) JUN-16 MO 2,316.00 2,316.00 ARC Exp. JUN-16 MO 1,495,108.00 1,495,108.00 ARC Exp. Deferred*** JUN-16 MO (116,827.00) (116,827.00)EBT FS GA/GR APR-16 MO (254,169.02) (254,169.02)CalWORKS EBT Theft JUN-16 MO 486.00 486.00 Total Miscellaneous Adjustment 1,307,897.00 (140,469,808.04) (139,161,911.04)

TOTAL 59,017,746.00 7,601,891.96 66,619,637.96 Sch No. 020527TCOMMENTS:

*Family Support Subaccount Recoupment/ Deferment is occurred to adjust negative Calworks portion.**Child Poverty Subaccount recoupment for this month not purely from SCO distribution, some counties has leftover bal.***Due to overmatch of county's ARC allocation, amount is deferred until close-out.

STATEMENT OF CASH ADVANCE - AA190

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY - DEPARTMENT OF SOCIAL SERVICES

CONTACTS:EBT INQUIRES: Bob Ficenec @ (916) 654 - 1749 FISCAL SYSTEMSCOUNTY ASSISTANCE PAYMENT UNIT ADVANCE MONTH: September 2016PAYMENT PROBLEMS: AA190 AND CLAIM LETTER INQUIRIES COUNTY: ControlSHOULD BE ADDRESSED VIA [email protected] Warrant Release Date: August 31, 2016

ASSISTANCE PROGRAM FEDERAL STATE TOTALFEDGAP ASST & KINGAP ASST

ADVANCES (100%) (CFDA #93.090)FedGAP Asst SEP-16 MO 3,200,000.00 3,200,000.00 KinGAP Asst SEP-16 MO 3,800,000.00 3,800,000.00

Total Advances 3,200,000.00 3,800,000.00 7,000,000.00

ADJUSTMENT FOR PRIOR PERIOD:Actual Expenditures 0.00 FedGAP Asst JUN-16 MO 3,508,415.00 3,508,415.00 KinGAP Asst JUN-16 MO 4,244,875.00 4,244,875.00 Less: Advances 0.00 FedGAP Asst JUN-16 MO (3,000,000.00) (3,000,000.00)KinGAP Asst JUN-16 MO (3,800,000.00) (3,800,000.00)Net AdjustmentsFedGAP Asst JUN-16 MO 508,415.00 508,415.00 KinGAP Asst JUN-16 MO 444,875.00 444,875.00 Total Net Adjustments 508,415.00 444,875.00 953,290.00 Net Adjustment - Deferred Payment 0.00 Net Adjustment - Deferred Recoupment 0.00 0.00 Total Prior Period Adjustment 506,315.00 444,875.00 953,290.00

MISC. ADJUSTMENTFedGAP OP BEG 07/01/12 JUN-16 MO (16,908.00) (16,908.00)KinGAP 18 Plus JUN-16 MO 113,378.00 84,070.00 197,448.00

0.00 0.00 0.00 0.00 0.00 0.00

FedGAP Adv MAR-16 MO (2,100.00) 0.00 (2,100.00)CalWORKS EBT Theft OCT-15 MO 0.00 2,094.00 2,094.00

0.00 0.00 Fraud Recovery Incentive SEP-15 QTR 1,884.00 1,884.00 Fraud Recovery Incentive JUN-16 QTR 923,140.00 923,140.00 Total Miscellaneous Adjustment 1,019,394.00 86,164.00 1,105,558.00

TOTAL 4,725,709.00 4,331,039.00 9,058,848.00

AS SHOWN ON REMITTANCE ADVICESFedGAP Asst 3,802,785.00 3,802,785.00 CALWORKS Asst 58,978,914.00 (46,725,516.02) 12,253,397.98 CWKS Safety Net Asst 34,461,244.00 34,461,244.00 CWKS TANF Timed-Out Asst 14,537,819.00 14,537,819.00 CWKS Diversion Asst 38,832.00 3,256.00 42,088.00 KinGAP Asst 4,328,945.00 4,328,945.00 CWKS Recent Non-Citizens Mixed Cases 2,961,270.00 2,961,270.00 CWKS Recent Non-Citizens TANF Timed-Out 62,854.00 62,854.00 CWKS Recent Non-Citizens NonFederal 1,176,367.00 1,176,367.00 EBT FS GA/GR (254,169.02) (254,169.02)Fraud Recovery Incentive 925,024.00 925,024.00 ARC 1,378,281.00 1,378,281.00 CalWORKS EBT Theft 2,580.00 2,580.00

TOTAL REMITTANCE 63,745,555.00 11,932,930.96 75,678,485.96 Sch No. 020527TCOMMENTS: