Forms

Title Effective Date
DSS-6187: Application for State Maternity Funds (Voucher, Social History & Service Plan) Problem Pregnancy Services Jan 23, 2020 01:05 PM
DSS-6187I: Instructions for Completing Application for State Maternity Fund DSS-6187 Jan 23, 2020 01:05 PM
DSS-6188: Notice of Action on Request for State Maternity Home Funds Jun 03, 2016 02:25 PM
DSS-6189: State Maternity Fund Residential Care Provider Agreement Jun 03, 2016 02:25 PM
DSS-6211: State Abortion Fund Eligibility Certification May 01, 2006 05:00 PM
DSS-6226: NC Division of Vocational Rehabilitation Services and County Social Services Agency/Department Referral Oct 26, 2016 02:35 PM
DSS-6228: NC Vocational Skills Training and Skills Recertifiation Plan (DSS-6228) Sep 07, 2018 02:35 PM
DSS-6229: NC Vocational Skills Training And Skills Recertification Agreement Plan of Action Requirements (DSS-6229) Sep 07, 2018 02:40 PM
DSS-6230: NC Refugee Assistance Program Family Self-Sufficiency Plan Jun 03, 2016 02:40 PM
DSS-6231: NC Refugee Assistance Program Service Plan Jun 03, 2016 02:45 PM
DSS-6232: NC Refugee Assistance Program Employability Plan Jun 03, 2016 02:45 PM
DSS-6233: Client (ELT) Service Plan Jun 03, 2016 02:45 PM
DSS-6234: ELT Learner Initial Assessment Form Jun 03, 2016 02:50 PM
DSS-6235: Quarterly Review Form Jun 03, 2016 02:50 PM
DSS-6236: Informed Consent For Release Of Information Jun 03, 2016 02:50 PM
DSS-6237: DSS Refugee Client Rights Form Jun 03, 2016 02:50 PM
DSS-6238: Refugee Cash Assistance Eligibility Monitoring Guide Jun 03, 2016 02:55 PM
DSS-6239A: Refugee Mutual Responsibility Agreement Jun 03, 2016 02:55 PM
DSS-6239B: Refugee MRA Plan of Action Requirements Jun 03, 2016 03:00 PM
DSS-6240: Simplified Nutritional Assistance Program (SNAP) Application Dec 31, 2020 11:15 AM
DSS-6241: Refugee Cash Assistance (RCA) Application Jun 20, 2018 03:00 PM
DSS-6242: Refugee Medical Assistance (RMA) Application Jun 20, 2018 03:05 PM
DSS-6246: Affidavit of Paternity Jun 03, 2016 03:05 PM
DSS-6247: Notification of *Refugee Arrival and Intent to Apply for Benefits May 17, 2018 03:05 PM
DSS-6852: Authorization / Receipt for Direct Payment Jun 03, 2016 03:10 PM
DSS-6901: Work First Employment Services Assessment Form Jun 03, 2016 03:10 PM
DSS-6902: Screening for Child Well Being Mar 16, 2017 03:10 PM
DSS-6904: Work First Information Transmittal Jun 03, 2016 03:10 PM
DSS-6905: Work Experience/Community Service Agreement Feb 12, 2018 03:15 PM
DSS-6960: Job Search/Verification Log Jun 01, 2018 03:15 PM