Yes! You can use AI to fill out California Department of Social Services, Sworn Statement

The GEN 853 Sworn Statement is a legal document required by the California Department of Social Services for individuals to provide factual statements under penalty of perjury. This form is crucial for various social service cases as it serves as official testimony, and providing false information can have serious legal consequences. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
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Form specifications

Form name: California Department of Social Services, Sworn Statement
Number of pages: 1
Language: English
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How to Fill Out GEN 853 Online for Free in 2026

Are you looking to fill out a GEN 853 form online quickly and accurately? Instafill.ai offers the #1 AI-powered PDF filling software of 2026, allowing you to complete your GEN 853 form in just 37 seconds or less.
Follow these steps to fill out your GEN 853 form online using Instafill.ai:
  1. 1 Navigate to Instafill.ai and upload or select the GEN 853 Sworn Statement form.
  2. 2 Use the AI assistant to automatically fill in case information such as County, Case Name, Worker Name, and Notice Date.
  3. 3 Enter your personal details, including your full name, address, and contact phone numbers.
  4. 4 Carefully type your declaration into the main text field, ensuring the statements are true and correct to the best of your knowledge.
  5. 5 Review all entered information for accuracy and completeness before proceeding.
  6. 6 Electronically sign and date the form in the designated signature block to certify your statement.
  7. 7 Securely download, print, or share your completed GEN 853 form directly from the platform.

Our AI-powered system ensures each field is filled out correctly, reducing errors and saving you time.

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Our AI performs 10 compliance checks to ensure your form is error-free.

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Frequently Asked Questions About Form GEN 853

This form is a legal document used to provide a formal statement of facts related to your social services case. By signing it, you are declaring under penalty of perjury that the information you provide is true and correct.

You need to complete this form if your county social services caseworker has requested a sworn statement from you. It is often used to clarify information or provide details about your situation.

Your Case Name, Worker Name, and Worker Number should be listed on the notice or correspondence you received from the county social services office. If you cannot locate this information, contact your caseworker directly.

In the large box following 'I declare as follows:', you must write the specific facts or information your caseworker has asked for. Be clear, truthful, and as detailed as necessary to answer their request.

The form allows for two signatures, which might be necessary if two adults in the household need to attest to the same facts. If you are the only person making the statement, you likely only need to sign once, but confirm this with your caseworker.

This is a legal declaration that you are swearing the information provided is true. Knowingly giving false information on this form is a crime and can lead to legal consequences.

No, the form is marked as a 'Required Form - No Substitutes Permitted'. You must use the official GEN 853 form to provide your sworn statement.

You should return the signed form to your county social services office or directly to your caseworker. Use the worker's contact information at the top of the form if you have questions about submission.

Yes, services like Instafill.ai use AI to accurately auto-fill your personal information like name and address, which saves time and helps prevent errors. The actual declaration, however, must be your own statement.

You can use a service like Instafill.ai to upload the form and fill it out on your computer or mobile device. This allows you to type your information directly into the fields for a clean, legible document.

If you have a non-fillable or 'flat' PDF, you can use a tool like Instafill.ai to make it interactive. Simply upload the form, and the service will convert it into a fillable version you can complete online.

The 'Notice Date' is the date the form or the request for the statement was issued by the county. This date should be on the letter or notice you received with the form.

For a minor error, you can neatly cross out the mistake and write your initials next to the correction. If you make a significant error, it is best to contact your caseworker and request a new, blank form.

Compliance GEN 853
Validation Checks by Instafill.ai

1
Validates County is an Official California County
Checks if the entered county name exists in the official list of 58 California counties. This is crucial for routing the form to the correct local agency and ensuring jurisdiction is correct. A failed validation would prevent submission until a valid county is entered.
2
Ensures Primary Signature is Present
Verifies that the 'First Signature or Mark' field is not empty, as it is marked 'REQUIRED'. A sworn statement is legally invalid without a signature, so this check is mandatory for the form's purpose. If the signature is missing, the form submission will be blocked and the user will be prompted to sign.
3
Validates Signature Date is Logically Correct
Confirms that the 'First Date Signed' is on or after the 'Notice Date'. A person cannot legally attest to a notice before it has been issued. This check prevents chronological errors and ensures the legal timeline of events is sound, rejecting submissions with an invalid date sequence.
4
Standardizes Date Field Formatting
Ensures that all date fields, including 'Notice Date' and 'Date Signed', adhere to a consistent format like MM/DD/YYYY. This prevents data entry errors and ensures dates are parsed correctly by backend systems for record-keeping and legal purposes. An invalid format would trigger an error message requiring the user to correct the entry.
5
Conditional Requirement for Second Signature Date
This check ensures that if the 'Second Signature or Mark' field is filled, the corresponding 'Second Date Signed' field must also be filled. A signature is incomplete without a date to establish when it was made. Failure to provide the date would result in an error, prompting the user to enter the date or clear the second signature.
6
Verifies Declarant Full Name Completeness
Validates that the 'Declarant Name' field contains, at a minimum, a distinct first name and last name. A full legal name is required for proper identification on a legal document. The system will flag incomplete entries to ensure the identity of the person making the sworn statement is unambiguous.
7
Confirms Declaration Content is Provided
Checks that the main 'Declaration Content' text area is not empty. The entire purpose of a sworn statement is the statement itself, so this field is absolutely required. An empty declaration would render the form meaningless and the submission will be rejected until content is added.
8
Validates Phone Number Structure
This rule checks that the 'Work Phone/Fax', 'Home Telephone Number', and 'Contact/Cell Phone Number' fields, if filled, match a standard 10-digit US phone number format. Proper formatting is essential for ensuring the contact information is usable and can be correctly dialed or stored. Incorrectly formatted numbers will be flagged for correction.
9
Validates ZIP Code Format and State Consistency
Ensures the 'Declarant Zip Code' is a valid 5-digit or 9-digit (ZIP+4) US postal code. It also cross-references the ZIP code to confirm it aligns with the 'Declarant State' field, which should be California. This validation improves data quality for mailings and address verification.
10
Ensures All Required Case Information is Present
Verifies that the 'Case Name', 'Worker Name', and 'Worker Number' fields are all completed. This information is critical for internal tracking, routing the document to the correct caseworker, and associating it with the proper file. The form cannot be processed without this key identifying data.
11
Restricts Declarant State to California
This validation checks that the 'Declarant State' field is entered as 'CA' or 'California'. Since this is a State of California form for a county agency, the declarant's address is expected to be within the state for jurisdictional purposes. Submissions with an out-of-state address may be flagged for review or rejected.
12
Logical Sequence of Signature Dates
If both signature dates are present, this check verifies that the 'Second Date Signed' is on or after the 'First Date Signed'. It is logically impossible for the second signature to predate the first on the same document. This maintains the chronological integrity of the signing process and prevents data entry mistakes.
13
Requires Full Declarant Address
This rule ensures that if any part of the declarant's address ('Street Address', 'City', 'State', 'Zip Code') is entered, all other parts are also completed. A partial address is unusable for official mailings or location verification. This check enforces the collection of a complete and valid mailing address.
14
Verifies Worker Number Format
Checks that the 'Worker Number' field conforms to a predefined agency-specific format, such as a certain number of digits or an alphanumeric pattern. This ensures the number is valid and can be used to uniquely identify the worker in the system. An invalid format would indicate a typo and prevent the form from being correctly assigned.

Common Mistakes in Completing GEN 853

Leaving Case Information Fields Blank

Applicants often do not have their Case Name, Worker Name, or Worker Number readily available and leave these fields blank. This is a critical error as it prevents the agency from linking the sworn statement to the correct case file, leading to significant processing delays or rejection. To avoid this, always have your case correspondence handy when completing the form; AI-powered tools like Instafill.ai can also help by storing and auto-filling this recurring information accurately.

Incorrectly Formatting the Declarant's Name

The form explicitly asks for the name in 'Last, First, Middle' format, but many people habitually write their name as 'First Last'. This simple mistake can cause data entry errors in the agency's system, potentially leading to mismatched records or difficulty locating the declarant's file. Always read field labels carefully; using a form-filling tool can also ensure the name is automatically formatted correctly based on the field's specific requirements.

Forgetting to Sign or Date the Declaration

A sworn statement is legally invalid without a signature and the corresponding date of signing. Forgetting to sign or date the form is a common oversight that results in its immediate rejection, forcing the applicant to start the process over. Always perform a final review of the document before submission, paying special attention to the signature and date fields to ensure they are completed.

Providing a Vague or Incomplete Declaration

The 'I declare as follows' section is the most important part of the form, yet people often provide statements that are too brief, emotional, or lacking in specific facts, dates, and details. An unclear declaration fails to serve its purpose and will likely be returned with a request for more information, delaying the case. To avoid this, write a clear, factual, and detailed account, focusing only on relevant information.

Submitting a Form with Illegible Handwriting

Since this is a legal document, it is often printed and filled out by hand, but poor handwriting can make names, numbers, and the declaration itself unreadable. This may force the agency to reject the form, causing significant delays. To prevent this, print clearly in block letters or use a tool like Instafill.ai, which can convert flat, non-fillable PDFs into electronically fillable versions to ensure perfect legibility.

Omitting the County Name at the Top

The 'COUNTY OF' field is located prominently at the top of the form but is surprisingly easy to overlook. Submitting the form without the county name means it cannot be routed to the correct local office, causing major delays or even the loss of the document. Always start filling out a form from the very top to ensure preliminary fields like this are not missed.

Misunderstanding the Second Signature Block

The presence of two separate signature blocks can confuse applicants, who may not know if one or two signatures are required. This can lead to a missing required signature (if a co-declarant was necessary) or an unnecessary second signature, both of which can create processing issues. If you are unsure, contact your case worker for clarification on who is required to sign the document.

Entering Incorrect or Inconsistent Dates

The form requires both a 'Notice Date' and a 'Date Signed,' and users may confuse them, leave one blank, or use an improper format. An incorrect 'Notice Date' can cause confusion, while an incorrect 'Date Signed' can raise legal questions about the document's validity. To avoid this, reference the original notice for the 'Notice Date' and ensure the 'Date Signed' accurately reflects the day you sign the document. AI tools like Instafill.ai can help by inserting the current date in the correct format.

Failing to Provide a Valid Contact Phone Number

Applicants sometimes skip the 'Home' or 'Cell' phone number fields, believing them to be optional. However, not providing a reliable contact number prevents the case worker from calling with simple questions, turning a five-minute clarification into a weeks-long delay via postal mail. Always provide at least one current phone number to ensure your case can proceed smoothly.

Using a P.O. Box for the Street Address

Many government forms require a physical residential address for verification purposes, but people sometimes enter a P.O. Box for convenience or privacy. This can lead to the form being flagged and returned with a request for a valid street address, delaying the entire process. Unless the form explicitly states a P.O. Box is acceptable, always provide your full physical street address.
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