Lynne A. Valenti
Cabinet Secretary

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Below you will find the selected forms and/or publications for this order. You will need to indicate the quantity you want to receive in the box next to the document number. After you have entered the quantity, click "Update" in the previous box. If you wish to remove a form or publication, simply click on the link that states "Delete." Once you have entered the quantity for each form or publication, click the "Proceed" button at the bottom.

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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