PPS 9121 Department for Children and Families REV
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Include: Name, Agency, Mailing Address, Telephone Number, Fax Number and E-mail Address
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New Address
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Other Contact Information Change
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_9000_Forms/PPS9121.pdf
KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES
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I. EBT Accounts/Case Numbers 4
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VI. Aged/Expired/Expunged Benefits 9
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Undelivered/Bad Address/Homeless EBT Card Procedures 21
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https://content.dcf.ks.gov/EES/KEESM/Appendix/New EBT Guide - KEES.pdfView duplicates
IN THE UNITED STATES DISTRICT COURT DISTRICT OF KANSAS M.B. and S.E., through their next friend KATHARYN MCINTYRE, et al., Plaintiffs, V. LAURA HOW ARD, et al., Defendants. Case No
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https://www.dcf.ks.gov/Documents/Settlement/ExecutedSettlementandAttachments0708202002.pdf
form shall also be used to update any information as necessary, i.e., name or address change
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Updating Affiliate Name Updating Affiliate Address Updating Affiliate Role F Faammiillyy F
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 002 Individual Background Check.pdf
*physical address required, including 9-digit zip code **the Total Expense for this column
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If the requested funding change is less than 10% of the (original) line item amount from
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https://www.dcf.ks.gov/Agency/Operations/Documents/Revision(OGC-1008.3).pdf
Language(s) Spoken in the Home
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July 2019 Page 3 of 7 (To be Updated Annually, or for Significant Change
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Address if they live in the home all of the time or part of the time, and why
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5318.pdf
*physical address required, including 9-digit zip code **the Total Expense for this column
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If the requested funding change is less than 10% of the (original) line item amount from
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https://www.dcf.ks.gov/Agency/Operations/Documents/Contract Revision(OGC-2005) ACCESSIBLE 5-17.pdf
resource will not be used, (4) report a change in the placement resource and/or type of care, (5) report a change of address, and 6) close an ICPC case
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It is an extremely useful tool
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_9000_Forms/PPS9135_instr.pdf
This training will address the Privacy element only
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better able to continue health care coverage for existing conditions when you change jobs
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https://www.dcf.ks.gov/Agency/Documents/HIPAA-Training.pdf
If you need help or have
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address and signature on Page 3 and return the form
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You must re-register each time you change your name, address, or party affiliation for voting
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Street Address
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3100_11-20.pdfView duplicates