PDF
Word
Form AD830 Summary Claim for Reimbursement - Private Agency Reimbursement Program - California
What Is Form AD830?
This is a legal form that was released by the California Department of Social Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the Form AD830?A: The Form AD830 is a summary claim for reimbursement.
Q: What is the Private Agency Reimbursement Program?A: The Private Agency Reimbursement Program is a program in California that provides reimbursement for services provided by private agencies.
Q: Who can use the Form AD830?A: Private agencies participating in the Private Agency Reimbursement Program can use the Form AD830.
Q: What is the purpose of the Form AD830?A: The Form AD830 is used to submit a summary claim for reimbursement to the Private Agency Reimbursement Program.
Form Details:
- Released on June 1, 1999;
- The latest edition provided by the California Department of Social Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form AD830 by clicking the link below or browse more documents and templates provided by the California Department of Social Services.
Download Form AD830 Summary Claim for Reimbursement - Private Agency Reimbursement Program - California
1
2
