Position/Title of individual completing referral
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Email address of individual completing referral
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Phone number of individual completing referral
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Which services are you interested in
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https://www.dcf.ks.gov/services/RS/Documents/RS Forms/General.Referral.Pre-ETS.pdf
State of Kansas Department for Children and Families PPS 6130 Prevention and Protection Services REV July 23 ADOPTION ASSISTANCE AGREEMENT
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Check the appropriate box below: This
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6130.pdf
State of Kansas PPS 5258a CCEP Program Department for Children and Families REV 8/11/22
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from the invoice, include them in your e-mail so the payment can be processed without delay
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5258A.pdf
State of Kansas Department for Children and Families IS-4315 Economic and Employment Services
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Employment Services (ES) Referral to Vocational Rehabilitation (VR) Client
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CN Email
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https://content.dcf.ks.gov/EES/KEESM/Forms/IS-4315EmploymentServicesReferraltoVocationalRehabilitation08-21.pdfView duplicates
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
Grant Manual GRANTEE VERSION Kansas Department for Children and Families Department of Administrative Services Office of Grants and Contracts 555 S Kansas Avenue, 5th Floor Topeka
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https://www.dcf.ks.gov/Agency/Operations/Documents/GRANT.MANUAL-GRANTEE-Version 1.3.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
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