CalFresh Authorized Representative Form: Filing the TEMP 2201

In California, you appoint someone to act on your CalFresh case by completing a CalFresh authorized representative form and submitting it in writing to your county social services office. Which form you use depends on what you want the person to do: the TEMP 2201 designates someone to hold an EBT card in their own name, while the CalFresh application itself (CF 285, SAWS 1, or SAWS 2 Plus) has a section for naming someone to file paperwork or handle reports on your behalf.¹ The head of household, a spouse, or another responsible adult in the home can make the designation at any point during the case, and a verbal request to your worker will not do it.²

Pick the Form That Matches the Authority You Want to Grant

An authorized representative can handle two very different jobs, and the paperwork splits along that line.

If you want someone to apply for CalFresh, complete your Semi-Annual Report (SAR 7), sit through the eligibility interview, or fill out work registration forms for you, the designation can be made directly on your application. The CF 285, SAWS 1, and SAWS 2 Plus each include a section for naming an authorized representative, so no separate form is needed when you are already applying or recertifying.¹

If you want someone to have their own EBT card and buy food on your behalf, you need the TEMP 2201, titled “Cash Aid/Food Stamp Electronic Benefit Transfer – EBT Request for a Designated Alternate Card Holder/Authorized Representative.” It is available at your county social services office.³ You can grant one role or both, and you can split them between two different people if that suits your situation.⁴

How to Fill Out the TEMP 2201

The TEMP 2201 asks for a short list of specifics. Fill in each of the following before signing:³

Case name and case number, exactly as they appear on your county correspondence.
The name of your assigned county eligibility worker.
Action type. Check the box for adding a new representative, changing an existing one, or removing someone.
The representative’s full legal name and date of birth.
A reliable phone number for the representative.
Signatures and dates from both you and the representative.

The form also asks you to check whether the person is a “designated alternate cardholder,” an “authorized representative,” or both. A designated alternate cardholder gets an EBT card in their own name but has no authority over your application or reporting. An authorized representative with EBT access gets the card and the ability to interact with the county about your case. Choose the combination that reflects what you actually want the person to do.

How to Submit the Form

Once both signatures are on the form, submit it to your local county social services office. You have a few options:

In person, during business hours or through an after-hours drop box if your office has one.
By mail, to the address printed on your CalFresh correspondence.
Online, through BenefitsCal. Log in, choose the document upload option, and attach a scanned or photographed copy of the signed form.⁵

Missing signatures are the most common reason a county rejects the form. Before you send it, confirm that both you and your representative have signed and dated it. If the county cannot verify both signatures, the designation will not be processed and you will have to resubmit.

What Happens After the County Processes an EBT Designation

Once the designation is on file, the state issues a separate EBT card in your representative’s name. The representative has to call EBT customer service to set their own PIN before the card will work at authorized retailers. The card gives them access to your entire CalFresh EBT balance, not a portion of it, so the person you name should be someone you genuinely trust with your grocery money.³

Who Cannot Serve as Your Representative

Most adults qualify. The person does not have to live with you or be related to you, but they do need to know enough about your household’s income, size, and living situation to give the county accurate information. Some people are barred from the role regardless of your preference:

County employees involved in CalFresh eligibility determinations.
Employees of retailers authorized to accept CalFresh benefits.
Employees of homeless meal providers authorized to accept CalFresh.
Federally funded application assisters.

These exclusions exist to prevent conflicts of interest.⁶ A person who has been disqualified for an intentional program violation generally cannot serve during the disqualification period; the only exception is when that person is the sole adult in the household and no one else is available.⁷ Community organizations, advocacy agencies, and CalFresh application assister organizations cannot serve either; the role has to go to an individual, not an institution.

Your Household Is Responsible for What the Representative Reports

This is the part on the form that is easy to miss. When you name an individual authorized representative, your household is legally responsible for repaying any overissuance of benefits that results from incorrect information the representative gives the county. The liability stays with your household even if the representative gave the wrong information without your knowledge.⁶ The county is supposed to explain this to you before finalizing the designation, but the warning appears in fine print on the form itself.

There is one narrow exception. When an employee of a drug and alcohol treatment center or group living arrangement acts as the authorized representative for a resident, the institution, not the household, bears responsibility for any overissuance.⁶

Changing or Removing Your Representative

You can change or revoke your representative at any time. To do it, submit a new TEMP 2201 with the “Change” or “Remove” box checked, or contact your county eligibility worker directly.³

If your representative has an active EBT card, one more step is on you. Call EBT customer service at 1-877-328-9677 to cut off their access to your account. Removing the representative from your county case file does not automatically deactivate the card, and until you make that call the old card may still work at the register. Any purchases made in that gap are yours as the account holder.

1
County of Santa Clara Social Services Agency. Notification to Household and Designation of an AR
2
California Department of Social Services. Food Stamp Regulations Eligibility Standards – Section 63-402.6
3
California Department of Social Services. Cash Aid/Food Stamp Electronic Benefit Transfer – EBT Request for a Designated Alternate Card Holder/Authorized Representative
4
County of Santa Clara Social Services Agency. CalFresh Authorized Representative
5
BenefitsCal. Reporting Features Awareness Update
6
DPSS ePolicy. CalFresh 63-402.6 Authorized Representatives
7
eCFR. 7 CFR 273.2 – Office Operations and Application Processing