Lynne A. Valenti
Cabinet Secretary

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CopiesEdit the Number of CopiesDocument NumberDocument NameDelete
1EditPosterConstituent Liaison Services PosterDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditEA-307SNAP Exit FormDelete
1EditEA-297Energy Assistance ApplicationDelete
1EditBH-08Mental Health - IMPACT ApplicationDelete
1EditBRO/CPS2Common Sense Parenting BrochureDelete
1Edit Recipient Forms: HIPAA Privacy Consent FormDelete
1EditFACISInterstate Compact: Report on Child PlacementDelete
1EditCPS-506Foster/Adoptive Parent Health ReportDelete
1EditCPS-593Permission to Screen for Reports of Abuse or NeglectDelete
1EditBH-11bAdult SUD Update Outcome ToolDelete
1EditCPS-566Foster Parent EvaluationDelete
1EditMS-102Provider Selection FormDelete
1EditBRO/MS3Well-Child Care BrochureDelete
1EditEA-269Child Care Expense Billing InformationDelete
1EditBRO/DSS9DSS HandbookDelete
1EditDSS-ORFI-831Estate Recovery Notification of Death FormDelete
1EditEA-260Statement of EarningsDelete
1EditCPS-549Request for Screening for Substantial Reports of Abuse and Neglect (unregistered family day care providers ONLY)Delete
1EditSE408CPApplication and Agreement for Services - Custodial Parent and/or CaretakerDelete
1EditDSS-W9W-9 FormDelete
1EditEA-269Child Care Expense Billing InformationDelete
1EditEA-214SNAP 6 Month Report FormDelete
1EditEA-307GSNAP Group Home Exit FormDelete
1EditEA-347Application for Social Security NumberDelete
1EditBRO/DCS3Income and Wage Withholding Brochure - Information for SD Employers, Financial Institutions, and Other Payors of IncomeDelete
1EditSE-406Application for Location Only ServicesDelete
1EditPosterCHIP PosterDelete
1EditEA-305Boarding School-Institution DocumentationDelete
1EditCCSOrientation Training Verification FormDelete
1EditOS-954Client Authorized Debit for Repayment of OverissuanceDelete
1EditBRO/EA4TANF Work Program BrochureDelete
1EditBRO/EA1Energy Saving TipsDelete
1EditDSSGuide to Administrative Hearings ProcedureDelete
1EditBRO/EA10SNAP for StudentsDelete
1EditBRO/CCS3Registration & Licensure of Child Care EnvironmentsDelete
1EditDSSPsychiatric Residential Treatment Facility Referral FormDelete
1EditCPSDesignated Tribal Agent Request for Change of AddressDelete
1EditEA-319Request for Administrative HearingDelete
1EditCCSPathways to Professional Development - Renewal ApplicationDelete
1EditEA-320Self-Employment LedgerDelete
1EditMS-146Sterilization Consent FormDelete
1EditBRO/DCS8Child Support Parent HandbookDelete
1EditSE-405Application for Income Withholding Only ServiceDelete
1EditFACISInterstate Compact: Placement Request FormDelete
1EditCPS-500Newborn Medical Report for Voluntary Termination of Parental RightsDelete
1EditBH-05Hardship Considerations RefusalDelete
1EditBH-11Behavioral Health Treatment Outcomes Program ManualDelete
1EditDSS-CPSSafe Havens PosterDelete
1EditBH-04102b Hardship ConsiderationsDelete
1EditBRO/MS1Medical Assistance Program Recipient HandbookDelete
1EditENERGYVendor Information: Direct DepositDelete
1EditBH-03102a Hardship Considerations Delete
1EditBH-02Financial Eligibility FormDelete
1EditCCSElectronic Payment ExemptionsDelete
1EditBH-17Prevention - Accreditation ApplicationDelete
1EditSE-415Petition for Modification FormDelete
1EditBRO/RE1Stop Benefit Fraud BrochureDelete
1EditBH-07Mental Health - Accreditation ApplicationDelete
1EditBRO/CPS3Safe Havens BrochureDelete
1EditBRO/DCS1Child Support Modification HandbookDelete
1EditRec and FraudReport Benefit FraudDelete
1EditBRO/EA11Weatherization Assistance BrochureDelete
1EditCPSPlacement Resource Monthly Reporting Form Ages 14 and olderDelete
1EditFSSAChildren and Family Medical Assistance ApplicationDelete
1EditEA-301SNAP ApplicationDelete
1EditBRO/MS4Title XIX Medical Transportation BrochureDelete
1EditCPSICPC Financial and Medical PlanDelete
1EditPAPrior Authorization Forms: Durable Medical Equipment and NutritionDelete
1EditPAPrior Authorization Forms: Private Duty Nursing & Extended Home Health ServicesDelete
1EditSE-431AChild Support Payment Authorization FormDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditBRO/EA8Medicaid Spousal Care HandbookDelete
1EditCPSBackground Information for Voluntary Termination of Parental RightsDelete