Forms & Publications :: SD Dept. of Social Services

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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Copies	Edit the Number of Copies	Document Number	Document Name	Delete
1	Edit	Poster	Constituent Liaison Services Poster	Delete
1	Edit	EA-208	Authorization to Furnish / Release Information	Delete
1	Edit	EA-307	SNAP Exit Form	Delete
1	Edit	EA-297	Energy Assistance Application	Delete
1	Edit	BH-08	Mental Health - IMPACT Application	Delete
1	Edit	BRO/CPS2	Common Sense Parenting Brochure	Delete
1	Edit		Recipient Forms: HIPAA Privacy Consent Form	Delete
1	Edit	FACIS	Interstate Compact: Report on Child Placement	Delete
1	Edit	CPS-506	Foster/Adoptive Parent Health Report	Delete
1	Edit	CPS-593	Permission to Screen for Reports of Abuse or Neglect	Delete
1	Edit	BH-11b	Adult SUD Update Outcome Tool	Delete
1	Edit	CPS-566	Foster Parent Evaluation	Delete
1	Edit	MS-102	Provider Selection Form	Delete
1	Edit	BRO/MS3	Well-Child Care Brochure	Delete
1	Edit	EA-269	Child Care Expense Billing Information	Delete
1	Edit	BRO/DSS9	DSS Handbook	Delete
1	Edit	DSS-ORFI-831	Estate Recovery Notification of Death Form	Delete
1	Edit	EA-260	Statement of Earnings	Delete
1	Edit	CPS-549	Request for Screening for Substantial Reports of Abuse and Neglect (unregistered family day care providers ONLY)	Delete
1	Edit	SE408CP	Application and Agreement for Services - Custodial Parent and/or Caretaker	Delete
1	Edit	DSS-W9	W-9 Form	Delete
1	Edit	EA-269	Child Care Expense Billing Information	Delete
1	Edit	EA-214	SNAP 6 Month Report Form	Delete
1	Edit	EA-307G	SNAP Group Home Exit Form	Delete
1	Edit	EA-347	Application for Social Security Number	Delete
1	Edit	BRO/DCS3	Income and Wage Withholding Brochure - Information for SD Employers, Financial Institutions, and Other Payors of Income	Delete
1	Edit	SE-406	Application for Location Only Services	Delete
1	Edit	Poster	CHIP Poster	Delete
1	Edit	EA-305	Boarding School-Institution Documentation	Delete
1	Edit	CCS	Orientation Training Verification Form	Delete
1	Edit	OS-954	Client Authorized Debit for Repayment of Overissuance	Delete
1	Edit	BRO/EA4	TANF Work Program Brochure	Delete
1	Edit	BRO/EA1	Energy Saving Tips	Delete
1	Edit	DSS	Guide to Administrative Hearings Procedure	Delete
1	Edit	BRO/EA10	SNAP for Students	Delete
1	Edit	BRO/CCS3	Registration & Licensure of Child Care Environments	Delete
1	Edit	DSS	Psychiatric Residential Treatment Facility Referral Form	Delete
1	Edit	CPS	Designated Tribal Agent Request for Change of Address	Delete
1	Edit	EA-319	Request for Administrative Hearing	Delete
1	Edit	CCS	Pathways to Professional Development - Renewal Application	Delete
1	Edit	EA-320	Self-Employment Ledger	Delete
1	Edit	MS-146	Sterilization Consent Form	Delete
1	Edit	BRO/DCS8	Child Support Parent Handbook	Delete
1	Edit	SE-405	Application for Income Withholding Only Service	Delete
1	Edit	FACIS	Interstate Compact: Placement Request Form	Delete