Initial Request Change Suspend / Terminate Date Effective: Date Effective: Date Effective
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Mentor Name: NA SSN & DOB: Address: Phone #: Email: Will the Mentor be the
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_7000_Forms/PPS7210.doc
AS THE SOUL FAMILY LEGAL PERMANENCY RESIDENTIAL CUSTODIAN: (initial each statement
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______I have received a copy of the PPS 6320, SOUL FAMILY LEGAL PERMANENCY Change Status Form
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6302.doc
Department for Children and Families IHI www.dcf.ks. g ov fJ Foster Care Licensing Division: 555 SW Kansas Avenue, 2nd Floor Topeka, KS 66603 Kansas Laws and Regulat ions for Juvenile
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/Juvenile Crisis Intervention Center Laws and Regulations June 2024.docx.pdf
KANSAS DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES
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Please address referrals or questions to the appropriate staff below
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72
Regulation 8 -- Change of Placement Purpose
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https://www.dcf.ks.gov/services/PPS/Documents/ICPCtrainingmanual.pdf
Yes No Date of Change: Date of change: 6. Youth became emancipated
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Yes No Date of Change: Date of change: 9. Youth has accessed Independent Living Services and
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6320.doc
focus of this team is to read cases in every stage to address issues early and frequently
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procedure, or KAECSES to make meaningful change to our collections and other performance
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2021/SC on Child Support Enforcement and Collection Testimony.pdf
in Receiving State: Name of Resource: Address: Type of Care: Placement Change Effective Date of Change: Name of Resource: Address: Type of Care: SECTION III COMPACT
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_9000_Forms/PPS9135.doc
Acknowledgment of Referral / Change / Closure
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Address
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SECTION V Case Status Change
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☐ Court venue change (custody only / services transfer to another region
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☐ Family did not sign Family Case
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4205.docx
move to new state New Address: Child-only move to new state New Address: Reason: Family new phone/email New
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_9000_Forms/PPS9121.doc
Information: Name of Parent 1: Email Address: Cell Phone #: Name of Parent 2: Email Address: Cell Phone #: Street Address: City, State and Zip Code: County of
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5318.doc