Page 1 SS-5033 REV-9/13 (for office use
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that the answers I have given to question 14
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laws and rules that control the CSS Program change from time to time. You may request a new
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https://www.dcf.ks.gov/services/CSS/Documents/SS5033 4-2014.pdfView duplicates
State of Kansas ADOPTIVE PLACEMENT AGREEMENT PPS 5343 Department for Children and Families Rev
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a. Change of address
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Name Address Telephone Type of Information
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Residential Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5343.pdf
State of Kansas Appendix 7A Department for Children and Families
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REV Jul-15 Prevention and Protection Services Page 1 of 6
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State and Regional Youth Advisory Councils
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_7A.pdf
SECTION I: Note: This is a Change of Venue This was an open Family Preservation case
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Email address
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If ICWA applies, has tribe been
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Mother’s address
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Father’s address
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E-Mail Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5110.pdf
☐ Change of Child Placing Agency Name
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☐ Change of program type
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Agency Name: Licensed Program Type: Facility Address: License Number: I/we request an
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 652 Amendment for CPA.pdf
for Amendment Use this form to request a change of the family foster home license capacity
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Submit the completed request and supporting documents to DCF.FCLExceptions@ks.gov
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Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 407 Family Foster Home Request for Amendment.pdf
: When submitting an application, either an initial or renewal, do I need to have all documents
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also submit documents via fax at (785)296-8609 or by sending them to the following address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FAQ.pdf
N, O, P, Q or R
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Change of address caused by P-EBT will be addressed at next IR or Review
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- Follow normal processes to update the address in KEES if the case head contacts the agency
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https://content.dcf.ks.gov/EES/KEESM/Policy_Memo/20-05-04Pandemic-EBTPhase1.pdfView duplicates
State of Kansas Adoption Exchange Child Status
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E-mail address
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Change of Venue (when that venue is moved to another contractor
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Name of new contractor: Date of change of venue
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5315.pdf
may be or has been subject to a name change at the time of adoption; the party requesting
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this Authorization with the final decree of adoption verifying a change of name, if any
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5365.pdf