Lynne A. Valenti
Cabinet Secretary

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CopiesEdit the Number of CopiesDocument NumberDocument NameDelete
1EditEA-301Economic Assistance ApplicationDelete
1EditCCSPayment Authorization FormDelete
1EditBRO/DSS4Direct Deposit BrochureDelete
1EditEA-214TANF 6 Month Report FormDelete
1EditRec and FraudEstate Recovery Program Petition for LimitationDelete
1EditEA-310Form for Reporting ChangesDelete
1EditPAPrior Authorization Forms: GeneralDelete
1EditSE408NCPApplication and Agreement for Services - Non-Custodial Parent Delete
1EditBRO/CPS18Family Group Conferencing – Provider Guide Delete
1EditBRO/CPS17Family Group Conferencing – Parents Guide Delete
1EditBH-18Mental Health - Indigent Medication Update - Extension Form 1.0Delete
1EditCPS-594Declaration of Prior Criminal Conviction & Military HistoryDelete
1EditPAPrior Authorization Forms: SynagisDelete
1EditEAWeatherization ApplicationDelete
1EditBH-01Federal Poverty Level GuidelinesDelete
1EditMS-103Provider Change FormDelete
1EditBH-19Substance Use Disorder High Intensity Referral FormDelete
1EditCCSSouth Dakota Child Safety Seat Distribution ProgramDelete
1EditCPSPotential Placement StatementDelete
1EditBH-14Substance Abuse - Accreditation ApplicationDelete
1EditCPSFoster Parent HandbookDelete
1EditPosterReportable Disease List PosterDelete