S T A T E O F K A N S A S
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Email Address –Email address is required to register for KPCpay
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Log On, the user will be required to change their Password and setup Challenge Questions and
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https://www.dcf.ks.gov/services/CSS/Documents/KPCpay Presentation.Employer_2017.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
to the Learning Quest Handbook that address how the CSSI account will be registered for your
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documentation on the CSSI Program Information Change Form that can be obtained from the
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https://www.dcf.ks.gov/services/CSS/Documents/Child Support Savings Iniative Program Description.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
case is to be closed and a final Notice of Action is to be sent to
the last known address
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assistance, request necessary shelter expense information regarding
the address change
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https://content.dcf.ks.gov/EES/KEESM/Robo01-21/keesm9123.htmView duplicates
12
month report/application/review/change shall be processed using
all available
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12 month
report, Review or reported change by the household appears to
exceed the
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https://content.dcf.ks.gov/EES/KEESM/Robo02-24/keesm1322.htmView duplicates
U.S. Department of Health and Human Services
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Docking State Office Building, 5 th Floor Topeka, Kansas 66612-1570
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Address: 915 SW Harrison, 5 th Floor, Topeka, KS
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https://www.dcf.ks.gov/services/PPS/Documents/Other/FinalVersionSWAssessment_February2015.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
KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES NOTICE OF USE OF PRIVATE HEALTH INFORMATION THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU
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https://www.dcf.ks.gov/Agency/Documents/HIPPA-NOP.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