State of Kansas Independent Living PPS 7300
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Department for Children and Families Case Determination REV. Oct. 2019
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Prevention and Protection Services Page 1 of 1
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Email Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_7000_Forms/PPS7300.docx
(if different from above): Father’s name
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Name: Address: Phone Number: E-Mail Address: Section VI: Additional Information
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(Email to DCF 30 days prior to the end of aftercare
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5M.doc
Monthly invoices reporting line-item expenses for the invoiced month will be due by the 20th day of the following month
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Grantees will submit invoices and supporting documentation in
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https://www.dcf.ks.gov/services/RS/Documents/OIB_Attachment E.doc
Provider: Assigned Provider Staff: Phone: Email: Date Aftercare started: Agreement in
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Frequency and method of contacts between case manager and child/family
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3070.doc
Action Plan – Service Provider develops and documents method of delivering requested service
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Notification - A communication (e.g., EDI, email, fax, mobile device, publication, telephone
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https://www.dcf.ks.gov/Agency/Operations/Documents/Appendix D - Abbreviation and Terminology.doc
If your child is attending school virtually either full or part-time for the 2020-2021 school year
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EES Email
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Save and attach to an email to the office serving the county where you live
https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/Instructions for Submitting Child 2020 School Schedule Form.docxView duplicates
Mailing Address (Street, City, State, Zip Code
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Email
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I/We agree to make monthly payments of $ __per month for consecutive months to complete repayment of the debt
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6180.doc
with a 10 day time limit
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Phone Call/text/e-mail to reschedule appointment or assignment: check the box if the CN attempted to call/text/e-mail the client and the date of the attempt
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https://content.dcf.ks.gov/EES/KEESM/Appendix/E-5PenaltyChecklistForCN03-19.docxView 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.docView duplicates
Child: minor under the age of 18
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Consul/consular officer: foreign government official
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Affairs through http://travel.state.gov/consularnotification or email at consnot@state.gov
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5E.doc