This agreement is being executed on this date, prior to the finalization of
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b. To participate in an annual review by completing and returning the review form within 30 days of receipt
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6130.doc
suspended if we do not receive the completed review form and we determine that you are no longer
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Another review form is enclosed for you convenience
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_6D.doc
Please return a copy of this form when sending your verifications
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Complete application/review form
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Copy to file, copy to customer This form supersedes Form ES-3105.1, 07-13
https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3105 1_02-16.docxView duplicates
to continue, you must complete the enclosed review form and return it not later than
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You may return the review form by mail, in person or through a medical or authorized
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https://content.dcf.ks.gov/EES/KEESM/Forms/PDF 3820_10-11.docView duplicates
At review the household will be sent only the Notice of Eligibility Review, the review form and Good for You nutrition newsletter
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Late Receipt of Review Form
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https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/Implementation Memo Rev 49final_9-29-11.docxView duplicates
The Case Plan Review form (PPS 3055) is used to review progress on the case plan with the family
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3051_Instr.docView duplicates
This form is required to be completed with the TANF review form you will receive separately in the mail
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Return this form with your TANF review paperwork
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3100DT_CoverLetter.docxView duplicates
We are returning your form for assistance
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Your 12 Month Report Form was not signed; please review the information on the form, sign and date page and return the entire
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https://content.dcf.ks.gov/EES/KEESM/Appendix/P-15_UnsignedApplicationLetter_01-19.docView duplicates
To ensure timely processing this form and all documents must be submitted to the fiscal agent within 30 days from receipt of this form
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Medical Review of Emergency Services 10-01
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https://content.dcf.ks.gov/EES/KEESM/Miscform/MS-2156_10-01.docView duplicates
Not Met if you do not
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Track CAP corrections on this form and document the date corrections are received
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(Or note) Score 1 Review p/p Policies, Procedures or Documents Substantially Met
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400G.doc