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Form Number [Sorted] Title [Sort] Categories [Sort] [?] File Format [?]
Form 1

I-9 (Employment Eligibility Verification)

HRM

PDF++

Form 1164

Purchase of Service Reimbursement Request

FIN

PDF+

Form 1204

SCCAP Application Cover Letter

FNP

PDF++

Form 1205

Declaration and Consent to Participate in the SCCAP

FNP

PDF++

Form 1230 A

Father Involvement and Marriage Questionnaire

FI

PDF++

Form 1230 A SPA

Cuestionario de Matrimonio y la Participación del Padre

FI

PDF

Form 1234 SPA

Formulario de Referencia/Comunicación del Cliente

FNP/FI

PDF

Form 1247

Medical Release/Physician's Statement

FI

PDF++

Form 1247 A

Medical Release/Physician's Statement – Required In-Home

FA

PDF++

Form 1247 B

Family Independence Self Evaluation Activities of Daily Living

FA

PDF++

Form 1247 C

Family Independence Program Certification of Necessary Treatment

FA

PDF++

Form 1299

SCCAP Excess Expense Letter

FNP

PDF

Form 1319

Supervised Job Search Log – Job Search Verification

FA

PDF++

Form 1320

Basic Learning Disability Screening

FA

PDF++

Form 1321

Family Independence Hearing Questionnaire

FA

PDF++

Form 1322

Excused Absence Log

FA

PDF++

Form 1323

FI Non-Compliance Checklist

FA

PDF++

Brochure 1436

Sexual Harassment Policy

HRM

PDF

Form 1474

Employee Exit Survey

HRM

PDF++

Brochure 1499

Employment Information Brochure

HRM

PDF

Form 1513

Original Licensing/Relicensing/Changes for Foster Home Licensing

CFAS

PDF++

Form 1524

Notice of Change in Child-Placing Agency's Foster Family Home License

CFAS

PDF++

Form 1527

Application for a Child-Placing Agency's Foster Family Home License

CFAS

PDF

Form 1538

DSS Transportation Log

CFAS

PDF++

Form 1571

Reference Letter for Foster/Adoptive Applicant

HS

PDF+

Form 1572

Application to Foster Care/Adoption

HS

PDF++

Form 1572 SPA

Solicitud para CrianzaTemporal/Adopción

HS

PDF

Form 1574

Medical Report Form for Prospective Foster/Adoptive Parent

HS

PDF+

Form 1575 A

Biological Family History Information

ADOPT

PDF

Form 1619

Change Report Form for Non-Earners

FNP/FI

PDF++

Form 1620

Change Report Form for Six-Month Reports

FNP/FI

PDF++

Form 1620 SPA

Formulario Para Reportar Cambios en un Plazo de Seis Meses

FA

PDF++

Form 1633

Application for Participation for Child Care and Adult Day Care Centers in the Child and Adult Care Food Program (CACFP)

CACFP

PDF++

Form 1641

Monthly Claim for Reimbursement

FS

PDF

Form 1641 1

Multi-County Listing Claim for Reimbursement

FS

PDF

Form 1645

Application for Free and Reduced-Price Meals in Adult Care Food Programs

FNP

PDF

Form 1650

Child and Adult Care Food Program Child Enrollment Form

CACFP

PDF++

Form 1668

Authorization for Special Investigation

FS

PDF

Form 1903

Case Review and Change Report for IV-E Foster Care

FA

PDF+

Form 1905

Referral for Field Operations and IV-E Eligibility Determination

FA

PDF+

Form 1908

Application for IV-E Eligibility

FA

PDF+

Brochure 2402

Problem Pregnancy Here's Help

ADOPT

PDF

Brochure 2408

Administrative Disqualification Hearings

IPR

PDF

Brochure 2408 SPA

Audiencias de Descalificación Administrativa

IPR

PDF

Brochure 2410

Fair Hearings

IPR

PDF

Brochure 2410 SPA

Audiencias Correctas e Imparciales

IPR

PDF

Brochure 2412

The Adoption Option

ADOPT

PDF

Brochure 2416

Know Your Civil Rights in Social Services Programs

AS

PDF

Brochure 2416 SPA

Sepa Sus Derechas Civices en Los...

IPR/CR

PDF

Brochure 2419

Adoption Guidelines and Steps to Adoption

ADOPT

PDF

Brochure 2422

Questions and Answers About Food Stamps

FS

PDF

Brochure 2444

Food Stamp Employment and Training Program

FI

PDF

Brochure 2444 SPA

Estampillas Alimenticias Programa de Empleo y Adiestramiento

FI

PDF

Brochure 2475

Important Information About Nonrecurring Costs for Parents Who Have Adopted a Child With Special Needs

ADOPT

PDF

Brochure 2493

Daniel's Law

PA

PDF

Brochure 2495

Faith-Based Initiative

CRD

PDF

Flyer 2496

The Safe Haven for Abandoned Babies Act

HS

PDF

Poster 2497

The Safe Haven for Abandoned Babies Act

HS

PDF

Form 2533

MEPA Educational Materials

ADOPT

PDF

Form 2534

Licensed Professional's Statement

ADOPT

PDF

Form 2540

Shaken Baby Video

ADOPT

PDF

Form 2601

Civil Rights Discrimination Complaint Form

IPR/CR

PDF

Form 2601 SPA

Formulario de Quejas por Discriminación de los Derechos Civiles

IPR/CR

PDF+

Form 2633

Request for Fair Hearing

IPR

PDF+

Form 2633 SPA

Solicitud para Audiencia Correcta e Imparcial

IPR

PDF+

Form 2647

State and Federal Fingerprint Review Transmittal Form

INV

PDF++

Form 2647 1

State and Federal Fingerprint Review Transmittal Form (Resubmit Only)

INV

PDF++

Form 2665

Certification for $8 Reduced Criminal Record Search Fee

INV

PDF++

Form 2700 1

Custodial Parents Application for Child Support Services

CSE

PDF

Form 2700 1 SPA

Solicitud Para el Padre/La Madre en Custodia de Servicios Para la Manutención Para Menores

CSE

PDF

Form 2719 1

Change of Custodial Parent's Application for Child Support

CSE

PDF

Form 2719 1 SPA

Cambio de la Solicitud del Padre/la Madre con Custodia para Manutención para Menores

CSE

PDF

Form 2719 2

Change of Custodial Parent's Application for Child Support

CSE

PDF

Form 2719 2 SPA

Cambio de la Solicitud del Padre/la Madre con Custodia para Manutención para Menores

CSE

PDF

Form 2719 3

Change of Custodial Parent's Application for Child Support

CSE

PDF

Form 2719 3 SPA

Cambio de la Solicitud del Padre/la Madre con Custodia para Manutención para Menores

CSE

PDF

Form 2719 4

Change of Custodial Parent's Application for Child Support

CSE

PDF

Form 2719 4 SPA

Cambio de la Solicitud del Padre/la Madre con Custodia para Manutención para Menores

CSE

PDF

Form 2719 5

Change of Custodial Parent's Application for Child Support

CSE

PDF

Form 2719 5 SPA

Cambio de la Solicitud del Padre/la Madre con Custodia para Manutención para Menores

CSE

PDF

Form 2810

Physician's Report

CSE

PDF

Form 2900

General Record and Statement of Child's Health for Admission to Child Care Facility

DC

PDF

Form 2901

Child Care Regulatory Services Medical Statement

DC

PDF

Form 2905

Sanitation Inspection Request: Child Care Facility

DC

PDF

Form 2908

Child Care Reference Release Statement

DC

PDF

Form 2909

Family Child Care Home Consumer Parent Statement

DC

PDF

Form 2924

Consent to Release Information

DC

PDF

Booklet 2955

S.C. Child Care Licensing Law

DC

PDF

Brochure 2966

A Guide to Key Regulations

FA/Child Care Services

PDF

Form 2967

Exemption Verification

DC

PDF

Brochure 2969

Emergency Procedures for Child Care Providers

DC

PDF

Brochure 3001

Our Children, Our Future

FPCWS

PDF

Brochure 3001 SPA

Nuestros Niños, Nuestro Futuro

HS

PDF

Form 3006

Suspected Child Abuse and Neglect Referral for Health Professional...

CFAS

PDF++

Form 3008

Child Factors Checklist

ADOPT

PDF

Brochure 3034

Child Protective Services: A Guide for Parents

CPS

PDF++

Brochure 3034 SPA

Servicios de Protección a Menores: Una Guía para los Padres

CPS

PDF++

Card 3039

Helpline Phone Card

FPCWS

PDF

Brochure 3066

Caring for Children... Caring for Families... Caring for the Future

CPS

PDF

Brochure 3066 SPA

CPS

PDF

Form 3072

Consent to Release Information

HS

PDF++

Form 3072 SPA

Permiso para Divulgar Información

HS

PDF+

Form 3082

Abandoned Infants Form for Safe Havens

CPS

PDF++

Form 3087

Safety Plan

CPS

PDF++

Form 3249

Verification of Application for Social Security Number

FS

PDF

Form 3314 A

Claim for Reimbursement/Afterschool Snack Program

FA

PDF++

Form 3321

Claim for Reimbursement

FNP/CACFP

PDF++

Form 3329

Pre-Approval Training Checklist for Child-Care Home Providers

FNP

PDF

Brochure 3333

Food Stamps Can Help!

SFSP

PDF

Brochure 3344

Seniors Farmers' Market Nutrition Program

SFSP

PDF

Brochure 3351

The Commodities Program

CACFP

PDF

Brochure 3352

SCCAP Are you on Supplemental Security Income?

CACFP

PDF

Form 3353

Attendance Record

CACFP

PDF++

Form 3354

Infant Statement

CACFP

PDF+

Form 3354 SPA

Declaración Sobre Infante

FA

PDF+

Form 3356

Afterschool Snack Program Site Information Form

CACFP

PDF++

Form 3357

Afterschool Snack Program (ASP) Application for Participation

CACFP

PDF++

Form 3358

Emergency Shelter Food Program (ESP) Facility Information Form

FA

PDF++

Form 3359

Emergency Shelters Program (ESP) Application For Participation

FA

PDF++

Form 3401 A

Claim for Reimbursement Addendum

FA

PDF++

Poster 3463

Do you have a complaint against the Food Stamp Program?

FI

PDF

Brochure 3464

Do you have a complaint against the Food Stamp Program?

FI

PDF

Form 3715

Gas Voucher

FI

PDF++

Brochure 3731

On-The-Job Training

FI

PDF

Form 3746 RUS

Head of Household Designation (Food Stamps)

FI

PDF

Form 3767

On-The-Job Training Agreement

FI

PDF++

Form 3774

ABC Child Care Voucher System Self-Arranged Child Care Provider Enrollment Form

FI

PDF

Form 3775

ABC Child Care Voucher System Self-Arranged Child Care Provider Agreement

FI

PDF++

Form 3776

ABC Child Care Voucher System Self-Arranged Child Care Parent Certification

FI

PDF

Brochure 3777

DSS and One-Stop Workforce Centers

FI

PDF

Form 3778

ABC Non-Regulated Provider Grant Reimbursement Request

FA

PDF+

Brochure 3780

Child Support and You

FI

PDF

Brochure 3785

FI Program: What it's all about.

FI

PDF

Form 3793

ABC Child Care Program Important Notification to Provider

FI

PDF++

Form 3794

ABC Child Care Voucher System Child Care Options

FI

PDF

Form 3800

Application for the FI Program, FS Program and Other DSS Assistance

FI

PDF++

Form 3800 SPA

Solicitud para el Programa de Independencia Familiar, Programa de Cupones (Estampillas) de Alimentos, Otra Asistencia de DSS

FI

PDF+

Form 3800 A

Your Rights and Responsibilities

FA

PDF++

Form 3800 A RUS

Your Rights and Responsibilities

FA

PDF

Form 3800 A SPA

Sus Derechos y Responsibilidades

FI

PDF

Form 3807 A

Mailed Recertification Form

FI

PDF++

Form 3807 A SPA

Formulario de Recertificación por Correo

FNP/FI

PDF++

Form 3808

Notice of Expiration

IS

PDF

Form 3808 SPA

Aviso de Vencimiento

PDF

Form 3816 B SPA

Referencia de Apoyo Infantil Datos del Padre Ausente

CHIP

PDF

Brochure 3905

Specialized Foster Home Services – Greenwood

MTS

PDF

Brochure 3905 1

Specialized Foster Home Services – Region IV

IFCCS

PDF

Form 12108

Verification of Receipt of Family Independence (FI) Benefits

FI

PDF

Form 16108

Emergency Food Assistance Program Food Loss Report

TEFAP

PDF++

Form 16119

Child and Adult Care Food Program Statement of Authority

CACFP

PDF++

Form 16168

Commodity Supplemental Food Program Application

FNP/CSFP

PDF++

Form 16169

Commodity Supplemental Food Program Participant Agreement

FNP/CSFP

PDF

Brochure 16173

Commodity Supplemental Food Program Attention Seniors

FNP/CSFP

PDF

Flyer 16174

Commodity Supplemental Food Program for Women, Infants and Children

FNP/CSFP

PDF

Form 16176

Application for the Food Stamp Program Simplified Application for the Elderly

FS

PDF++

Form 16176 SPA

Solicitud Simplificada para Personas de Mayor Edad

FA

PDF+

Form 16177

Elderly Simplified Application Project Letter

FS

PDF++

Form 16177 SPA

Proyecto de Solicitud Simplificada para los Ancianos

FA

PDF

Brochure 16178

Elderly Simplified Application Project Brochure

FA

PDF

Brochure 16178 SPA

Proyecto de Solicitud Simplificada para los Ancianos

FA

PDF

Form 16179

The Emergency Food Assistance Program Commodity Issuance Log

FNP

PDF++

Form 16180

The CSFP Nutrition Education Activity Sheet

FNP/CSFP

PDF++

Form 16181

Change Report Form for the Elderly Simplified Application Project (ESAP)

FA

PDF

Form 16182

CSFP Authorized Representative (Proxy) Designation Form

FA

PDF

Form 16183

Expedited Screening Worksheet

FI

PDF++

Form 16184

Food Stamp Case Review Sheet

FI

PDF++

Poster 16185

The Commodity Supplemental Food Program (CSFP) Income Eligibility Scale

FA

PDF

Poster 16186

The Emergency Food Assistance Program (TEFAP) Income Eligibility Scale

FA

PDF

Flyer 24118

SCEBT Information

FS/EBT

PDF

Brochure 24126

South Carolina Family Independence Information and Referral Services

FI

PDF

Brochure 24126 SPA

Servicios de Información y Referencia de Independencia Familiar de Carolina de Sur

FI

PDF

Poster 24127

Attention South Carolina EBT Recipients

FS/EBT

PDF

Form 27103

Non-Custodial Parent's Application for Child Support Services

CSE

PDF

Form 27105

Instructions for Financial Declaration

CSE

PDF

Form 27115

Notice for Parent Locate Service

CSE

PDF

Form 27126

Order/Notice to Withhold Income for Child Support and Notice of an Order to Withhold Income for Child Support

CSE

PDF+

Brochure 27137

You Matter – VIP Program

CSE

PDF

Brochure 27137 SPA

Usted Importa - VIP Program

CSE

PDF

Form 27151

Child Support Obligation: Worksheet A

CSE

PDF

Form 27156

Financial Declaration

CSE

PDF

Form 30100

Openness Checklist for Birth Parents

ADOPT

PDF

Form 30102

Medical Statement for Household Members

HS

PDF+

Form 30103

Intake Form

ADOPT

PDF+

Form 30165

Criminal Court Data

FPCWS

PDF++

Form 30201

Checklist for Foster/Adoptive Home Study

HS

PDF+

Form 30202

Medical Statement for Child

HS

PDF+

Form 30219

Discipline Agreement

HS

PDF+

Form 30220

Training Evaluation

HS

PDF+

Form 30221

Assessment of Applicant Participation in Foster/Adoptive Training

HS

PDF+

Form 30222

Interest Letter

HS

PDF++

Form 30224

Notice to Foreign Consul of Child Protection Proceedings

CPS

PDF++

Form 30224 SPA

Aviso para el Consulado Extranjero de un Procedimiento de Protección de Menores

HS

PDF+

Booklet 30230

Child Abuse, Child Neglect: What Parents Should Know if They Are Investigated

CPS

PDF

Booklet 30230 SPA

Abuso del Menor, Descuido del Menor: Lo Que Los Padres Deberían Saber Si Están Siendo Investigados

CPS

PDF

Brochure 30232

Domestic Violence

HS

PDF

Brochure 30232 SPA

La Violencia Doméstica

HS

PDF

Form 30233

Endangered Runaway Checklist for Case Managers

PDF

Brochure 30234

Multiethnic Placement Act

ADOPT

PDF

Form 30235

IL Mentoring Outline

HS

PDF

Form 30236

IL Tutoring Request and Progress Report

HS

PDF

Form 30237

IL Invoice for Youth Graduation Award

HS

PDF

Form 30238

IL Emancipation Budget Analysis Sheet

HS

PDF

Form 30239

IL Shower Request Form

HS

PDF

Form 30240

2008 Funding Request for Rental Assistance for Transition (RAFT)

HS

PDF

Form 37101

ABC Child Care Voucher System Participating Provider Enrollment Form

FI

PDF++

Booklet 37102

ABC Child Care Voucher Program Participating Provider Business Procedures

FI

PDF

Booklet 37103

ABC Child Child Care Voucher System Self-Arranged/In-Home Care Provider Business Procedures

FI

PDF

Booklet 37104

ABC Child Care Program Handbook for Parents

FI

PDF

Booklet 37105

ABC Child Care Voucher Program Enhanced Provider Business Procedures

FI

PDF

Form 37106 1

ABC Child Care Program: Level A Provider Agreement

FI

PDF++

Form 37106 2

ABC Child Care Program: Level B Provider Agreement

FI

PDF++

Form 37106 3

ABC Child Care Voucher System: Level C Provider Agreement

FI

PDF++

Form 37107

ABC Child Care Voucher System Enhanced Provider Rate Form

FI

PDF++

Form 37108

ABC Child Care Voucher System Enhanced Provider Enrollment Form

FI

PDF++

Form 37109

ABC Child Care Voucher System Fair Hearing Process Notice

FI

PDF++

Booklet

Child Support Guidelines 2006

CSE

PDF

   

South Carolina Department of Social Services

P.O. Box 1520 • Columbia, SC 29202-1520

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