DOB APPROVAL STAMP (If Required) Revised 05/03/2022
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Department for Children and Families Rebecca Gerhardt 785-296-3825
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Agency Agency Contact Contact Phone Number
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https://www.dcf.ks.gov/Newsroom/Documents/Economic_Impact_Statement-Rules_and_Regulations-JCIC 9-22-2023.pdf
Kansas Department of Social and
Rehabilitation Services
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Prepared by:
SRS Office of Financial
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Docking State Office Building, 915 S.W. Harrison, Topeka, KS 66612; (785) 296-6217; e-mail
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https://www.dcf.ks.gov/Agency/Documents/SSBG_StatePlan_SFY2012.pdf
(Donor must have picture ID to show to collection site personnel
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Type of Test to Be Conducted: Drug Test (NIDA/5) Panel
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Normal Collection - H39 Screen 5, PCP
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852-5201 or email
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https://content.dcf.ks.gov/ees/KEESM/Forms/ES-4108_Collection_Site_Passport.pdfView duplicates
Send a scan of the form to the EBT Unit as an attachment to an e-mail to DCF.EBTMAIL@ks.gov
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portions of the form are completed, email the completed form to the Administrative Office
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3142EBT_Ben_Repay05-22.pdfView duplicates
State of Kansas Department for Children and Families Prevention and Protection Kansas Statute Annotated
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_2A.pdf
The Kansas Department for Children and Families (DCF) works with approximately 750 youth from
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please call 785-296-3944 or send an email to dcf.H4H@ks.gov. Wrapped gifts and gift cards
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https://www.dcf.ks.gov/services/PPS/Documents/HopeForTheHolidays.pdf
V. HOW TO – DCF Administration TASKS
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Appendix C – Technical Document – Interest Report for 1099
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Appendix D – Technical Document – AFCARS Element 65
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Appendix E – Banking – How to Download
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_EP_D.pdf
Address Apt. # City State Zip Code Telephone E-mail County B. Do you appoint someone other
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Telephone Address Apt. # City State Zip E-mail State of Kansas Social and Rehabilitation
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https://www.dcf.ks.gov/Documents/Food/ES-3100.8_Application_Redetermination_01-06.pdf
you are testifying via WEBEX, be sure your email is provided in this cover letter so I can email the link to you prior to the meeting
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2023/HB 2021 DCF Written Only.pdf
Foster Care Bill of Rights- Page 1 of 6
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State of Kansas PPS-5138 Department for Children and Families 07/2023 Prevention and Protection Services Page 1 of 6
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(d) if going on a visit
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5138.pdf