The TEMP 2201 form is how a California CalFresh or CalWORKs recipient gives another trusted adult their own EBT card tied to the recipient’s account. Published by the California Department of Social Services and titled “Request for a Designated Alternate Card Holder/Authorized Representative,” it’s a single page you complete, sign with the person you’re naming, and submit to your county welfare office.1California Department of Social Services. TEMP 2201 – Request for a Designated Alternate Card Holder/Authorized Representative Once processed, the person you name gets an EBT card in their own name that draws from your account.
What the Form Actually Does
The designated person’s card is not a separate wallet. It pulls from your account, which means they have access to all of your CalFresh food benefits and all of your CalWORKs cash aid. There is no way to split the designation so that it covers only food, and no way to cap how much the designee can spend in a given trip.1California Department of Social Services. TEMP 2201 – Request for a Designated Alternate Card Holder/Authorized Representative
The form covers two overlapping roles, and you choose one or both with a checkbox. A Designated Alternate Card Holder can shop and withdraw cash aid. An Authorized Representative can also apply for CalFresh on your behalf, complete required reporting forms, and handle other program paperwork.2Santa Clara County Social Services Agency. Authorized Representative
When You Would File It
The usual reason is that the cardholder can’t easily get to a store. Elderly recipients, people with disabilities, recipients recovering from surgery or illness, and households where the cardholder works during store hours all use the form to let a trusted person shop for them. Federal regulations direct state agencies to help elderly, disabled, and rural households find authorized representatives when stores or offices are hard to reach.3eCFR. 7 CFR Part 274 – Issuance and Use of Program Benefits
You might also file it when a spouse, partner, adult child, or caregiver regularly does the household’s grocery shopping but isn’t the person named on the account. One note on scope: a Social Security representative payee does not automatically carry over to CalFresh. If you want the same person handling both, you have to designate them here.2Santa Clara County Social Services Agency. Authorized Representative
How to Fill It Out
You can download the TEMP 2201 from the CDSS forms page or pick up a copy at your county welfare office.4California Department of Social Services. Forms and Publications (Q-T) Most people finish it in a few minutes. The fields are:
- Case Name — your name exactly as it appears on your CalFresh or CalWORKs case.
- Case Number — the number assigned to your household’s case, printed on any notice from your county welfare office.
- Worker Name and Date — your assigned caseworker’s name and the date you’re filling the form in.
- Type of designation — check Designated Alternate Card Holder, Authorized Representative, or both; then check whether this is a new designation, a change, or a removal.
- Designee’s full legal name and date of birth.
- Your signature, date, and phone number. Signing acknowledges that the designee will have access to all your benefits and that the county is not responsible for what the designee spends.
- Designee’s signature and date. The person you’re naming confirms they agree to follow the rules of the cash aid and food stamp EBT program.
Both signatures are required for the form to be processed.1California Department of Social Services. TEMP 2201 – Request for a Designated Alternate Card Holder/Authorized Representative
Where to Submit It
Send or bring the completed form to your county welfare office.1California Department of Social Services. TEMP 2201 – Request for a Designated Alternate Card Holder/Authorized Representative Dropping it off in person is the fastest route; otherwise, mail it to the address printed on your county correspondence. After the county processes it, an EBT card in the designee’s name will be issued and linked to your account. Keep a signed copy for your records.
Changing or Removing a Designee
You’re not locked in. To swap in a different person, submit a new TEMP 2201 with the “Change” box checked and the new person’s information. To end the arrangement entirely, submit one with the “Remove” box checked. You can also call your caseworker to start either process.1California Department of Social Services. TEMP 2201 – Request for a Designated Alternate Card Holder/Authorized Representative
If you need to cut off access right away because of a dispute or suspected misuse, call EBT customer service at 1-877-328-9677. The form is explicit that terminating a designee’s access is your responsibility, and the county will not be liable for benefits spent before you revoke it.1California Department of Social Services. TEMP 2201 – Request for a Designated Alternate Card Holder/Authorized Representative The same number handles lost or stolen cards, whether yours or the designee’s.
What to Weigh Before You Name Someone
The point worth repeating: the designee gets everything on the account. Full monthly CalFresh allotment, full CalWORKs cash aid if you receive both. Pick someone you trust with that.
An authorized representative also needs to know enough about your household’s circumstances to handle program responsibilities correctly. If the county sends a reporting form and your representative fills it out wrong, your benefits can be affected. One person can serve as the authorized representative for more than one household, which comes up with caregivers who assist multiple clients.2Santa Clara County Social Services Agency. Authorized Representative