☐ Initial Request ☐ Change ☐ Suspend / Terminate Date Effective: Date Effective: Date
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_7000_Forms/PPS7210.docView duplicates
Change in status with sponsoring agency in regard to health and safety standards
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Change in operation (e.g., name change, address, telephone numbers, ownership, household members
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https://content.dcf.ks.gov/ees/KEESM/Robo10-24/Robo_10_01_24/keesm10034.htm
Mental Health Provider Email Address
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Placement Address
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School Address
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would then be the school in which the child is enrolled at the time of the placement change
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If yes to questions 4 and
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5254.docxView duplicates
☐ Change of Child Placing Agency Name
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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 8.24.pdf
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
Complete the section(s) regarding the change(s) you are reporting
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Change in the number of hours that child care is needed or used
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☐ Address Change
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What is your new address
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-1512.docxView duplicates
process outlines the processes when a consumer on a LIEAP case reports a change in address
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not run EDBC if the only update is an address change, unless the address is out of state
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https://content.dcf.ks.gov/ees/KEESWebHelp/NonMedical-KEESWebHelp/LIEAP_Change_in_Address_Process.htm
Do NOT change the address of a child in Foster Care
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If the consumer/household did not report the change of address to the agency AND did not respond to
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https://content.dcf.ks.gov/ees/KEESWebHelp/NonMedical-KEESWebHelp/Returned_Mail_Process.htm
TITLE IV-B CHILD AND FAMILY SERVICES PLAN ANNUAL PROGRESS AND SERVICES REPORT Submitted To
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voices and expertise to achieve a system in which significant and real change can be made
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https://www.dcf.ks.gov/services/PPS/Documents/CFSR/Kansas TITLE IV-B 2025 APSR-A.pdf
listed on the W9 form, that person’s SSN, address, and signature are required for this form
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completing and submitting the PPS 6320 SOUL Family Legal Permanency Change in Status Form
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6300.docx