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SS Forms

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    Please tell us if you need assistance because you do not speak English or have a disability. Free language assistance and/or other aids and services are available upon request. To receive free interpreter services, call 866-719-0141 or ask at the DSS local office. After the recorded message, you will reach an operator who can provide you with an interpreter. If you have a disability and need communication assistance, call 866-719-0141 or TTY: 711.

All Social Services Forms

Title
Appendix G SAIH Slot Request Form
APS Brochure
DAAS 20201 Special Assistance Second Party Review Form APPLICATIONS
DAAS 20202 Special Assistance Second Party Review Form RECERTIFICATIONS
DHB-5001N_UK: СПОВІЩЕННЯ ПРО ВИКОРИСТАННЯ НОМЕРІВ СОЦІАЛЬНОГО СТРАХУВАННЯ
DHB-5043: ФОРМА ПІДТВЕРДЖЕННЯ ДОХОДІВ ТА ВИТРАТ САМОЗАЙНЯТОЇ ОСОБИ
DHB-5200 Tagalog-ia Aplikasyon para sa Saklaw sa Kalusugan at Tulong sa Pagbabayad ng mga Gastos
DHHS AS 0008 Initial Notice to DA or LE Elec
DHHS-AS_6218 Adult Services Intake Inquiry HW 3 2024
DHHS-AS-0001 Adult Protective Services Intake
DHHS-AS-0002 Notice to Reporter Elec 3.2024
DHHS-AS-0003 Adult Services Notice to Administrator Elec 2024
DHHS-AS-0004 Notice to Reporter of Completion of Evaluation Elec 2024
DHHS-AS-0005 Community Evaluation HW 2024
DHHS-AS-0005_Community Evaluation Elec.2024
DHHS-AS-0006 Facility Evaluation HW 2024
DHHS-AS-0006_Facility_Evaluation_Elec_2024
DHHS-AS-0007_Diligent_Efforts_Elec_2024
DHHS-AS-0007_Diligent_Efforts_HW_2024
DHHS-AS-0009 Written Report of APS Evaluation Elec 3.2024
DHHS-AS-0009 Written Report of APS Evaluation HW 3.2024
DHHS-AS-0010 APS Notice to Financial Customer Elec
DHHS-AS-0011 Adult and Family Service Plan HW
DHHS-AS-0011_Adult_and_Family_Service_Plan _Elec
DHHS-AS-0013 Determination of Ability to Consent 2024
DHHS-AS-0013 Determination of Ability to Consent HW 3.2024
DHHS-AS-0014 Notice of Request for Record for Adult Protective Services Eval. Elec
DHHS-AS-0015 Consent for Financial Records HW
DHHS-AS-0016 Consent for Release of Information HW
DHHS-AS-0020-Guardianship Status Report 8.2024
DHHS-AS-5026 Form
DHHS-AS-6218 Adult Services Intake Inquiry Elec 3 2024
DHHS-AS-6219 Adult Services Face Sheet 3 2024
DHHS-AS-6219 Adult Services Face Sheet Elec 3.2024
DHHS-AS-6220 Annual Services Functional Assessment Elec 2024
DHHS-AS-6220-Annual Services Functional Assessment HW
DHHS-AS-6222 Adult Service Contact Activity Log HW 2024
DHHS-AS-6222 Adult Services Contact Activity Log Elec 2024
DHHS-AS-6223 Interim or Quarterly Review Elec 2024
DHHS-AS-6223 Interim or Quarterly Review HW 2024
DHHS-AS-6224 Adult Services Annual Assessment Elec 3 2024
DHHS-AS-6224 Adult Services Annual Assessment_HW_3_2024
DHHS-AS-6225: SAIH Program Assessment Electronic
DHHS-AS-6226 Case Closing Summary Elec 3.2024
DHHS-AS-6226 Case Closing Summary HW 3 2024
DHHS-AS-7016
DHHS-AS-Adult and Family Service Plan Elec
DHHS-AS-Adult Services Annual Assessment HW 2024
DHHS-AS-Request 5337 VA Request Template
DMA-5094: ПОВІДОМЛЕННЯ ПРО ВАШЕ ПРАВО ПОДАТИ ЗАЯВКУ НА ОТРИМАННЯ ДОПОМОГИ
DSS_5027_SIS_Client_Entry_Form
DSS_8173_KO: 기록 공개 동의서
DSS_8556_KO: 자격상실 심리 사전 통지서
DSS_8587_KO: 행정 자격상실 심리 포기에 따른 조치
DSS-0031 SAIH Program Interagency Referral Form
DSS-0032sp: Asistencia Especial En El Hogar – Certificación de Firma
DSS-0033: Appendix E, Supplement 1
DSS-0034: Appendix E, Supplement 2
DSS-10001_AR: اتفاقية خدمات اللغة (LEP) بالنسبة إلى العميل ذي المھارة المحدودة في اللغة الإنجليزية ، والعميل المصاب بضعف في الحواس
DSS-10001_DE: Für Kunden mit eingeschränkter englischer Sprachfähigkeit und Kunden mit beeinträchtigten Sinneswahrnehmungen
DSS-10001_FR: Accord Concernant Les Services Linguistiques
DSS-10001_KO: 제한적 영어 구사 능력(LEP) 고객 및 감각 장애 고객용
DSS-10001_VI: Dành Cho Khách Hàng Có Trình Độ Anh Ngữ Hạn Chế (Limited English Proficiency hay LEP) Và Khách Hàng Bị Suy Giảm Nhận Thức
DSS-10001-ia: СОГЛАШЕНИЕ О ЯЗЫКОВЫХ УСЛУГАХ
DSS-10001-ia: УГОДА ЩОДО ПОСЛУГ ІЗ ПЕРЕКЛАДУ
DSS-10001: Language Services Agreement
DSS-10001ins: Instructions for completing the DSS-10001
DSS-10001sp: Acuerdo Sobre Servicios De Lenguaje Para Personas con Capacidad Limitada en el Uso del Inglés Y Personas con Discapacidades Sensoriales
DSS-1167: Food and Nutrition Services ePass Application Verification Document
DSS-1168: Locate Data Sheet
DSS-1321: Statement of Admin. Expenditure for Purchased Service
DSS-1360: Work First Program Purchase of Services: Referral and Authorization
DSS-1402: CPS Intake Report
DSS-1402ins: CPS Intake Report Instructions
DSS-1403: North Carolina Requirement to Notify Child Protective Services (CPS) of Substance Affected Infant
DSS-1404: Care Management for At Risk Children (CMARC) Referral Form
DSS-1432: Application For Disaster Food and Nutrition Services
DSS-1432sp: División de Servicios Sociales de Carolina del Norte Solicitud de Servicios de Alimento y Nutrición por desastre
DSS-1451: Fire and Building Safety Inspection Report
DSS-1463: Title VI, Federal Civil Rights Act of 1964
DSS-1464: Statement of Assurance of Compliance with Title VI of Civil Rights Act of 1964
DSS-1464a: Statement of Assurance of Compliance with Title VI of the Civil Rights Act of 1964 for Other Agencies, Institutions, Organizations or Facilities
DSS-1473: Request for State Appeal
DSS-1473a: Request for State Appeal 1473-Addendum for Program Integrity
DSS-1473b: Request for State Appeal 1473-Addendum for Expedited MAD Medical Determination
DSS-1514: Fire and Building Safety Inspection Report (Institutional Building)
DSS-1515: Foster Home Fire Inspection Safety Report
DSS-1515sp: Reporte De Inspeccion Contra Incendios De Casa Foster
DSS-1516: Understanding Foster Care – A Handbook for Youth
DSS-1516sp: Entendiendo el Cuidado Foster–Libro para Jóvenes
DSS-1630: Application for Appointment of Personal Representative
DSS-1653: Report of Medical Examination
DSS-1656: Refund Receipt (Collection of Overpayment)
DSS-1662: Verification of Change in Situation
DSS-1662sp: Verificación de Cambio de Situación
DSS-1664: Report on Aid Needed by Inmate’s Dependents
DSS-1664sp: NC Departmento De Correccion Programa Work Release Reporte de Necesidad de Ayuda para Dependientes de un Interno
DSS-1665: Work First Cash Assistance Protective Payee Agreement
DSS-1665sp: Work First (Trabajar Primero) Asistencia Monetaria Acuerdo de Pago Protegido
DSS-1678_AR: إقرار خطي مشفوع بالقسم للاستبدال
DSS-1678_DE: Eidesstattliche Erklarung (Ersatz)
DSS-1678_FR: Declaration Sous Serment De Remplacement
DSS-1678_KO: 재지급 진술서
DSS-1678_VI: BẢN TUYÊN THỆ THAY THẾ
DSS-1678: Replacement/Supplement Affidavit
DSS-1678sp: Declaracion Jurada Para Solicitar Reemplazo De Beneficios
DSS-1682: Report of Erroneous Issuance
DSS-1688_AR: قسم الخدمات الاجتماعية تعيين ممثل مفوض
DSS-1688_DE: Ernennung eines befugten Vertreters
DSS-1688_FR: Désignation du représentant autorisé
DSS-1688_KO: 공식 대리인 지정
DSS-1688_VI: Chỉ Định Đại Diện Được Ủy Quyền
DSS-1688: Designation of Authorized Representative
DSS-1688sp: Designación de un Representante Autorizado
DSS-1700: Application Worksheet
DSS-1700sp: Hoja De Trabajo (Application Worksheet)
DSS-1783: Annual Statistical Report for Residential Child Care Facility
DSS-1789: Voluntary Placement Agreement
DSS-1789sp: Acuerdo de Colocacion Voluntario
DSS-1796: Agency/Foster Parents Agreement
DSS-1797: Inter-County Agreement on the Placement of Children
DSS-1798: Inter-Agency Adoption Agreement
DSS-1800: Petition for Adoption of a Minor Child
DSS-1800sp: Peticion De Adopcion De Un Menor
DSS-1801: Agency’s Consent to Adoption
DSS-1802: Consent to Adoption by Parent, Guardian, or Guardian Ad Litem of the Mother/Father
DSS-1802sp: Consentimiento De Adopcion Por Padre, Guardian Ad Litem, O Guardian
DSS-1803: Consent of Child for Adoption
DSS-1804: Relinquishment of Minor for Adoption by Parent or Guardian
DSS-1804sp: Renuncia A Un Menor Para Adopcion Por Padre O Guardian
DSS-1805: Revocation of Relinquishment for Adoption by Parent, Guardian, or Guardian Ad Litem of the Mother/Father
DSS-1805sp: Revocacion De Renuncia Para ADOPCION Por Padre O Guardian
DSS-1806: Revocation of Consent to Adoption by Parent, Guardian, or Guidian Ad Litem of the Mother/Father
DSS-1806sp: Revocacion De Consentimiento Para Adopcion Por Madre, Padre O Tutor
DSS-1807: Order for Report on Proposed Adoption
DSS-1808: Report on Proposed Adoption
DSS-1808ins: Instructions for Completing Form DSS-1808
DSS-1809: Affidavit of Parentage
DSS-1809sp: Declaracion De Paternidad
DSS-1810: Guardianship Assistance Agreement
DSS-1811: Medical Examination
DSS-1811sp: Examen Medico Como Parte Del Informe A La Corte
DSS-1812 Autorización General Para El Tratamiento Y Los Medicamentos
DSS-1812: General Authorization for Treatment and Medication
DSS-1812ins: General Authorization for Treatment and Medication Instructions
DSS-1813: Guardianship Assistance Eligibility Checklist
DSS-1814: Decree of Adoption
DSS-1815: Report to Vital Records (Not Stepparent or Adult)
DSS-1815sp: Informe Para El Registro Civil
DSS-1816: Dismissal of Adoption
DSS-1820: NC Kids Child Registration Form
DSS-1820ins: NC Kids Child Registration Form Instructions
DSS-1821: NC Kids Family Registration Form
DSS-1821ins: NC Kids Family Registration Form Instructions
DSS-1837: Interstate Compact on the Placement of Children Request (ICPC 100A)
DSS-1837I: Instructions for Completing Form ICPC-100A Interstate Compact on the Placement of Children Request
DSS-1838: Interstate Compact Report on Child’s Placement Status (ICPC 100B)
DSS-1838I: Instructions for Completing Form ICPC-100B Interstate Compact Report on Child’s Placement Status
DSS-1839: Regulation 7 Form Order for Expedited Placement Decision Pursuant to the ICPC
DSS-1841: Regulation # 2 Case Manager Statement of Interest
DSS-20221: SA Recertification Budget Sheet
DSS-2141: Monthly Requisition For Forms
DSS-2203: Daysheet
DSS-2204: Day Summary Sheet
DSS-2216: Request for Record
DSS-2239: IV-D Legal Services Bill
DSS-2249: Affidavit Of Adoption Expenditures
DSS-2250: Adoption Assistance Payment Authorization Notice
DSS-2435I_AR: شعار بانتهاء السريان ونموذج إعادة اعتماد المقابلة لبرنامج خدمات الطعام والتغذية
DSS-2435I_DE: Mitteilung über Ablauf von Lebensmittelleistungen und Formular für erneute Interviewbestätigung
DSS-2435I_FR: Services d’alimentation et de nutrition (FNS) Avis d’expiration et formulaire de renouvellement d’attestation
DSS-2435I_KO: 식품 및 영양 서비스(FNS) 만기 통지 및 면접 재인증 양식
DSS-2435I_VI: Mẫu Tái Xác Nhận và Thông Báo Hết Hạn và Phỏng Vấn Dịch Vụ Dinh Dưỡng và Thực Phẩm (Food and Nutrition Services hay FNS)
DSS-2435I_VI: Mẫu Tái Xác Nhận và Thông Báo Hết Hạn và Phỏng Vấn Dịch Vụ Dinh Dưỡng và Thực Phẩm (Food and Nutrition Services hay FNS)
DSS-2435i: Food and Nutrition Services (FNS) Notice of Expiration and Interview Recertification Form
DSS-2435isp: Servicios de Alimentos y Nutrición (FNS). Aviso de Expiración y Formulario de Entrevista de Re-Certificación
DSS-2435R_AR: إشعار بانتهاء السريان ونموذج إعادة اعتماد المقابلة لبرنامج خدمات الطعام والتغذية
DSS-2435R_DE: Mitteilung über Ablauf von Lebensmittelleistungen und Formular für erneute Zertifizierung
DSS-2435R_FR: Services d’alimentation et de nutrition (FNS) Avis d’expiration et formulaire de renouvellement d’attestation
DSS-2435R_KO: 식품 및 영양 서비스(FNS) 만기 통지 및 재인증 양식
DSS-2435R_VI: Mẫu Tái Xác Nhận và Thông Báo Hết Hạn Dịch Vụ Dinh Dưỡng và Thực Phẩm (Food and Nutrition Services hay FNS)
DSS-2435r: Food and Nutrition Services (FNS) Notice of Expiration Recertification Form
DSS-2435rsp: Alimentos y Nutrición (FNS). Aviso de Expiración y Forma de Re-Certificación
DSS-2435sri_AR: الحقوق والمسؤوليات
DSS-2435sri_DE: Rechte Und Verantwortungen
DSS-2435sri_KO: 권리와 의무
DSS-2435sri_VI: QUYỀN VÀ TRÁCH NHIỆM
DSS-2435sri: Rights and Responsibilities
DSS-2435srisp: Derechos Y Responsabilidades
DSS-2624: Food and Nutrition Services Referral Form
DSS-2625: Food and Nutrition Services E&T Information Transmittal
DSS-2807-II: Part II, Report on Local Hearings
DSS-2807: Part 1, Report on Local Hearings – Summary
DSS-2987_ES: Declaración del Propietario
DSS-2abl: First Notice to Work First Families with Two Adult Recipients Able to Work
DSS-3000 Appointment Follow-up Letter Regarding SA Assistance Request
DSS-3001: Notice of County of Residence Reassignment/Transfer
DSS-3001sp Notificación sobre reasignación o transferencia
DSS-3002 Agreement to Sell
DSS-3002sp Compromiso de venta
DSS-3003 Important Information About Your Special Assistance and Your Resources
DSS-3004 Referral to SSA for Waiver or Reduction of Overpayment Recoupment
DSS-3005 Documentation Regarding Continuation of Special Assistance When the LOC Is Upgraded, But No Bed Is Available
DSS-3006 Medical Care Special / Medical Expense Form
DSS-3431-ia sp: Fecha De Solicitud De Información Financiera
DSS-3431: Request for Financial Information
DSS-3449_DE: Genehmigung für vom Landwirtschaftsministerium der Vereinigten Staaten von Amerika gespendete Lebensmittel
DSS-3449_FR: Autorisation de dons de produits alimentaires du Département de l’agriculture des États-Unis (USDA)
DSS-3449_KO: 미농무부(USDA)가 기부한 식품에 대한 승인
DSS-3449_VI: Uỷ Quyền Nhận Thực Phẩm Được Quyên Góp Của USDA
DSS-4278: Reunification Referring Agency Referral Form
DSS-4279: Intensive Family Preservation Referring Agency Referral Form
DSS-4451: Application for Child Support Services
DSS-4451sp: Solicitud De Servicios De Sustento De Menores
DSS-4718: CSE Direct Deposit Authorization
DSS-4718sp: Autorizacion Para Deposito Directo
DSS-5002: Child Welfare Services Corrective Action Plan
DSS-5009: Fatality Notification
DSS-5009A: Instructions for Fatality Notification
DSS-5010: Structured Documentation Instrument for CPS Assessments
DSS-5010a: Continuing Need and Safety Requirements
DSS-5010ins: NC CPS Assessments Documentation Tool (DSS-5010) Instructions
DSS-5010sp Herramienta De Documentacion De La Evaluatcion De Los CPS De Carolina Del Norte
DSS-5012: Adoption Assistance Eligibility Checklist
DSS-5012sp: Lista Para Revisar Eligibilidad De Asistencia Por Adopcion
DSS-5013: North Carolina Adoption Assistance Agreement
DSS-5013sp: Acuerdo De Asistencia Por Adopcion De Carolina Del Norte
DSS-5015: Foster Care Facility Action Request
DSS-5016: Foster Home License Application
DSS-5016sp: Solicitud De Licencia Para Casa Foster
DSS-5017: Medical History Form
DSS-5017sp: Forma De Historial Medico
DSS-5018 Autorizacion De Hogares De Acogida Formulario De Evaluacion De Seguridad En Relacion Con El Agua
DSS-5018: Foster Home Licensing Water Hazard Safety Assessment Form
DSS-5018a: Foster Home Licensing Individual Water Hazard Safety Plan
DSS-5022: Refugee Work Registration Certification, Employment/Refusal and Termination/Denial Notice
DSS-5023: Direct Deposit Enrollment Authorization Form
DSS-5023sp: Forma de Autorización para Deposito Directo
DSS-5027: Client Entry Form
DSS-5027A: Client Entry – Purchase of Service Provider Form
DSS-5030: Confidential Intermediary Agreement
DSS-5031: Application for Confidential Intermediary Services
DSS-5032: Consent to Release of Information and/or Contact
DSS-5033: Release of Liability and Agreement to Hold Harmless
DSS-5094: Child Placement and Payment Report
DSS-5094a: Foster Care Visit Report
DSS-5094c: Child Placement and Payment Report Continuation Page
DSS-5095: NC DSS Child Placement and Payment System Adoption Assistance
DSS-5096A Plan De Hogar Transitorio
DSS-5096a: Transitional Living Plan For Youth/Young Adults in Foster Care
DSS-5096B: Plan De Hogar Transitorio
DSS-5096b: Transitional Living Plan – 90 Day Transition Plan for Youth in Foster Care
DSS-5096C: Plan De Hogar Transitorio
DSS-5096c: Transitional Living Plan – 90 Day Transition Plan For Young Adults In Foster Care 18 to 21
DSS-5096D: Plan De Hogar Transitorio
DSS-5096d: Transitional Living Plan – Helpful Resources For Young Adults
DSS-5097: Voluntary Placement Agreement for Foster Care 18 to 21
DSS-5098 Registro Mensual De Contactos
DSS-5098: North Carolina Monthly Contact Record For Foster Care 18 to 21
DSS-5099: Placement Agreement For Foster Care 18 to 21
DSS-5100: Semi-Supervised Independent Living Assessment Tool
DSS-5102: NC DSS Non-Identifying Background Information
DSS-5102sp: Historial, Sin Proporcionar Informacion Paraidentificar A Alguna Persona Especifica
DSS-5103: Adoption Health History
DSS-5103sp: Historial Clínico para Adopción, Parte I
DSS-5104: Report to Central Registry/CPS Application
DSS-5104a: Responsible Individuals List Form
DSS-5104c: Central Registry Report Continuation Page-Children
DSS-5104d: Modification/Deletion Request Form
DSS-5104p: Central Registry Report Continuation Page – Perpetrator
DSS-5105: North Carolina Diligent Efforts to Identify and/or Locate
DSS-5106: North Carolina Multiple Response System Case Tracking Form
DSS-5108A: DSS/Student Contractual Agreement for Continuing Residential Support CARS – Six Month Review
DSS-5108asp: Contrato de Estudiante/DSS para Apoyo residencial permanente (CARS) Revisión a los seis meses
DSS-5112: Adoption Assistance Vendor Payment Request Form
DSS-5113: Adoption Services Agreement
DSS-5115: Adoption Assistance Vendor Payment Instructions for Providers
DSS-5115sp: Programa De Asistencia Para Adopcion Instrucciones De Pago
DSS-5118: Denial of Paternity
DSS-5118sp: Negacion De Paternidad
DSS-5120: Determination of Foster Care Assistance Benefits and/or Medical Assistance Only
DSS-5120A: Re-determination of Foster Care Assistance Benefits and/or Medical Assistance Only
DSS-5120B: Additional Siblings in Removal Home
DSS-5120C: Additional Members of the Family Assistance Unit
DSS-5120E: Determination Of Foster Care 18 to 21 Assistance Benefits and/or Medical Assistance Only
DSS-5133: Foster Child Notification of Placement (Change) Form
DSS-5133ins: Foster Child Notification of Placement (Change) Form Instructions
DSS-5135: Foster Child Immediate Enrollment Form
DSS-5137: Best Interest Determination Form
DSS-5137a: North Carolina Best Interest Determination Meeting Override
DSS-5137sp: Formulario De Determinación De Mejor Interés
DSS-5143 Consent Form for Child Medical Evaluations Instructions
DSS-5143: Consent/Authorization For Medical/Mental Health Evaluation
DSS-5143sp: Consentimiento/Autorizacion Para Evaluacion De La Salud Medica/Mental Programa De Evaluacion Medica Del
DSS-5145: State of North Carolina Application for Reimbursement of Non-Recurring Adoption Costs
DSS-5145sp: Estado De Carolina Del Norte Solicitud Para REEMBOLSO De Costos No Repetitivos De Adopcion
DSS-5146: Agreement for Reimbursement of Non-Recurring Adoption Costs
DSS-5146sp: Estado De Carolina Del Norte Convenio Por Reembolso De Costo Costos No Repetitivos De Adopcion
DSS-5150: Foster Home Environmental Conditions Report
DSS-5150sp: Reporte De Condiciones De Casa Foster
DSS-5152-iisp: Componente Del Estado De Salud Del Nino(a)
DSS-5156: Medical Evaluation
DSS-5156sp: Evaluacion Medica
DSS-5157: Foster Home Relicense, Termination and Change Request Application
DSS-5157sp: Solicitud de Renovacion de Licencia de Casa Foster
DSS-5158: Foster Home Transfer Request Application
DSS-5158sp: Solicitud De Transferencia De Casa Foster
DSS-5159: Foster Home Change Request Application
DSS-5159sp: Solicitud De Cambio
DSS-5160 Solicitud De Cese Del Hogar De Acogida
DSS-5160: Foster Home Termination Application
DSS-5162: Petition for Adoption of a Minor Child (Step-parent)
DSS-5162sp: Solicitud Para ADOPCIÓN De Un(a) Nino(a) Menor
DSS-5163: Petition for Adult Adoption
DSS-5163sp: Solicitud Para Adopcion De Adulto
DSS-5164: Consent to Adoption by Adult Adoptee
DSS-5164sp: Consentimiento De Adopcion Por Adulto Adoptado
DSS-5165: Consent to Adult Adoption by Spouse of Petitioner
DSS-5165sp: Consentimiento Para Adopcion De Adulto Por Conyuge De Solicitante
DSS-5166: Decree of Adult Adoption
DSS-5167: Report to Vital Records for Adult Adoption
DSS-5167sp: Informe Al Registro Civil Para Adopcion De Adulto
DSS-5168: Revocation of Child’s Consent to Adoption
DSS-5168sp: Revocacion Del Consentimiento Para Adopcion Del Nino(a)
DSS-5169: Consent of Child for Adoption (Step-parent Adoption)
DSS-5169sp: Consentimiento Del Nino(a) Para Adopcion
DSS-5170: Report to Vital Records (Stepparent Adoption)
DSS-5189-iiisp: Departamento de Servicios Sociales ha programado una reunión del Equipo de Acción de Planeamiento de Permanencia
DSS-5189-iisp: Notice to Parent Regarding a Change in Placement of Children-Spanish
DSS-5189-isp: Notice to Parent Regarding Proposed Change in the Placement of Children-Spanish
DSS-5189-ivsp: Notice to Parent Regarding Permanency Planning Review Outcome
DSS-5189: Consent to Adoption by Parent Who is Spouse of Stepparent
DSS-5189I: Notice to Parent of Proposed Change in Placement of Child(ren)
DSS-5189II: Notice to Parent Regarding Proposed Change in the Placement of Child(ren)
DSS-5189III: Notice to Permanency Planning Review
DSS-5189IV: Notice to Parent Regarding Permanency Planning Review Outcome
DSS-5189sp: Consentimiento De Adopcion Otorgado Por Padre/Madre Que Es Conyuge De Madrastra/Padrastro
DSS-5190: Consent to Adoption by Parent Who Is Not the Stepparent’s Spouse
DSS-5190sp: Consent of Adoption by Parent who is not the Stepparent’s Spouse-Spanish
DSS-5191: Affidavit – Disclosure of Fees & Expenses
DSS-5191sp: Declaracion Jurada Divulgacion De Honorarios Y Gastos
DSS-5199: Foster Home Request for Waiver
DSS-5201: Understanding Foster Care – A Handbook for Parents
DSS-5203: Initial Provider Assessment
DSS-5203ins: Initial Provider Assessment Instructions
DSS-5203sp: Evaluación inicial del cuidado por parientes
DSS-5204: Comprehensive Provider Assessment
DSS-5204ins: Instructions for Comprehensive Provider Assessment
DSS-5204sp: Evaluación completa del cuidado por parientes
DSS-5206: Health Summary Form – Initial Visit
DSS-5207: Health History Form
DSS-5207ins: Health History Form Instructions
DSS-5208: Health Summary Form – 30-day Comprehensive Visit
DSS-5209: Health Summary Form – Well-Visit
DSS-5211: Special Children’s Adoption Incentive Fund – Request for Payment
DSS-5212: Supplemental Adoption Assistance Agreement
DSS-5212sp: Fondo De Incentivos Para La Adopcion De Ninos Especiales Convenio Complementario De Asistencia Para Adopcion
DSS-5213: Verification of Child’s Need for Daily Supervision
DSS-5214: Agency Verification of Legal Custody and Child’s Living Arrangement for Past Six Months
DSS-5215: Verification of Child’s Health Condition
DSS-5217: Request for Reimbursement Of Links Special Funds
DSS-5218: Consent to Release of Identifying Information
DSS-5219: Certificate of Delivery of Preplacement Assessment
DSS-5219sp: Certificado de entrega de la evaluación previa a la colocación
DSS-5225: Request for NC KIDS Legal Risk Search
DSS-5225sp: Peticion Para Investigacion De Riesgo De NC KIDS
DSS-5226: NC SDM Family Risk ReAssessment
DSS-5226sp: Carolina Del Norte Reevaluacion Del Riesgo Familiar De Abuso / Desciodo
DSS-5227: NC SDM Family Reunification Assessment
DSS-5227sp: SDM ® Evaluacion De Reunificacion Familiar
DSS-5229_ZH-CN: 北卡罗来纳州 家庭能力和需求评估
DSS-5229: North Carolina Family Assessment of Strengths and Needs
DSS-5229sp: Evaluacion De Los Aspectos Fuertes Y Necesidades De La Familia
DSS-5230: NC SDM Family Risk Assessment of Child Abuse/Neglect
DSS-5230sp: SDM ®Evaluacion De Riesgo Familiar De Abuso/Negligencia
DSS-5231 ia: Évaluation de la sécurité en Caroline du Nord
DSS-5231: North Carolina Safety Assessment
DSS-5231ins: North Carolina Safety Assessment Instructions
DSS-5231sp: Carolina Del Norte Evaluacion De Seguridad
DSS-5233: Personalized Domestic Violence Safety Plan
DSS-5234: Domestic Violence Perpetrator Assessment Tool
DSS-5235 – Non-Offending Parent/Adult Victim Domestic Violence Assessment Tool
DSS-5236: North Carolina Monthly In-Home Contact Record
DSS-5236ins – North Carolina Monthly In-Home Contact Record Instructions
DSS-5237: Children’s Domestic Violence Assessment Tool
DSS-5238: DSS Referral Form for Early Intervention Services (CDSA)
DSS-5239: In Home Family Services Agreement
DSS-5239ins: In-Home family Services Agreement Completion Instructions
DSS-5239sp: Acuerdo De Servicios De Familia En Casa De Carolina Del Norte
DSS-5239spa: Acuerdo de Servicios para la Familia en el Hogar
DSS-5240: Permanency Planning Family Services Agreement
DSS-5240ins: Permanency Planning Family Services Agreement Instructions
DSS-5240sp: Acuerdo De Servicios Familiares De Planificación De Permanencia En Carolina Del Norte
DSS-5241: Permanency Planning Review
DSS-5241ins: Permanency Planning Review Instructions
DSS-5241sp: Reviso de la Evaluación de Acuerdo de Servicios Familiares
DSS-5242: Family Time and Contact Plan (Visitation)
DSS-5242sp: Regimen De Visitas y Contacto
DSS-5245: Child Education Status
DSS-5245ins: Child Education Status Instructions
DSS-5246: Information Sharing Achnowledgement
DSS-5246sp: Acuse De Recibo De Informacion Compartida
DSS-5247: Information Sharing Partnership Agreement
DSS-5248: ICAMA Form 6.02, Notice of Action
DSS-5249: Icama Form 6.01, Notice of Medicaid Eligibility/Case Activation
DSS-5250: ICAMA Form 6.03, Report of Change in Child(ren) Family Status
DSS-5251: ICPC Financial-Medical Plan
DSS-5252: ICPC Sending State Priority Home Study Request
DSS-5253: ICPC Receiving State Priority Home Study Request
DSS-5255: ICPC Checklist for Interstate Placement Requests
DSS-5256: Drug Endangered Children Protocol: Initial Medical Assessment
DSS-5257: Drug Endangered Children Protocol – Placement Guidelines
DSS-5257: Protocolo para niños en peligro a la exposición de drogas: pautas de colocación
DSS-5258: Protocol for Field Assessment to Determine Need for On-Scene Decontamination Prior to Transport
DSS-5259: Drug Endangered Children Protocol: Exposure Record
DSS-5260: Drug Endangered Children Protocol Feedback Form: Law Enforcement
DSS-5261: Drug Endangered Children Protocol Feedback Form: Social Worker
DSS-5262: Drug Endangered Children Protocol Feedback Form: Health Care Provider
DSS-5263: Drug Endangered Children Protocol Feedback Form: Foster Care Provider
DSS-5264: Family Support Parent and Family Questionnaire – Client Satisfaction Survey
DSS-5264sp: Encuesta Sobre Servicios al Cliente – Programa de Ayuda a la Familia y Bienestar del Niño
DSS-5266: 24 Month Time Limit
DSS-5266sp: Estimada familia del programa Work First
DSS-5267: 60 Month Lifetime Limit
DSS-5267sp: Estimada familia del programa Work First Período de por vida de 60 meses
DSS-5268: Responsible Individuals List (RIL) Information Request
DSS-5268sp: Solicitud de Información: Lista de Individuos Responsables (RIL)
DSS-5271: Individual Criminal Violations Declaration Statement
DSS-5271sp: Declaración de Delitos Penales Individuales
DSS-5272: Facility ID Number Application
DSS-5273: Verification of Participation
DSS-5274: Request for Adjustment to Foster Care Assistance Payment
DSS-5275: North Carolina Residency Declaration
DSS-5275sp: Declaración de Residencia en Carolina del Norte
DSS-5276: North Carolina Residency Applicant Statement
DSS-5276sp: Declaración del solicitante de residencia en Carolina del Norte
DSS-5277: Request for Confidential Information Regarding Child Abuse, Neglect and/or Dependency
DSS-5278: Request for Placement Evaluation for Infant Born to an Incarcerated Mother
DSS-5279: Request for Revocation of a Foster Home License
DSS-5280: Notice Foster Home Mandatory Criminal History Check
DSS-5281 Critical Incident Reporting Form
DSS-5282: Notification of CPS Involvement
DSS-5283: Regulatory and Licensing Services Complaint Form
DSS-5283sp: División de Servicios Sociales de Carolina del NorteForma de Queja de Servicios de Regulaciones y Licencias
DSS-5285: Child and Family Services Review Protocol for Pilot Counties
DSS-5286: Stakeholder Questionnaire
DSS-5287: NC DSS Child and Family Services Review Protocol
DSS-5288: Notice of Extension Hearing
DSS-5288sp: Aviso De Audiencia De Extension
DSS-5288sp: Aviso De Audiencia De Extension
DSS-5290-B: Notice of Work First 60-Month State Time Clock Starting
DSS-5290-Bsp: Aviso de los 60 meses iniciales de su participación en el Programa Work First (Trabajar Primero)
DSS-5290: Notice of Work First 24-Month State Time Clock Starting
DSS-5291: Indian Child Welfare Act Compliance Checklist
DSS-5292: Work First Participation Summary
DSS-5292sp: Resumen De Participacion En El Programa Work First
DSS-5293: Notice of Hardship Exemption Hearing
DSS-5293sp: Aviso De Audiencia De Exencion Por Penuria
DSS-5294: Notice of Decision on Hardship Exemption Request
DSS-5294sp: Aviso De Decision Sobre Solicitud De Exencion
DSS-5295: Monthly Permanency Planning Contact Record
DSS-5295ins: Monthly Permanency Planning Contact Record Instructions
DSS-5295sp: Registro De Contacto Mensual De Padres Foster En Carolina Del Norte
DSS-5297: Consent for Release of Confidential Information
DSS-5297sp: Consentimiento para Divulgar Información Confidencial
DSS-5298: North Carolina’s Work First Family Assessment of Strengths and Needs
DSS-5298sp: Porgrama Work First de Carolina del Norte Evaluación de fortalezas y necesidades de la familia
DSS-5299: 24-Month Time Limit Checklist
DSS-5300: Notice of Decision on Extension Request
DSS-5300sp: Aviso De Decision Sobre Solicitud De Extension
DSS-5301: Extension Hearing Request
DSS-5301sp: Solicitud De Audiencia De Extension
DSS-5302: Work First Extension/Exemption Monthly Report
DSS-5303: Request for NC Kids Child Registration Exemption
DSS-5303sp: Peticion De Excepcion De Registro Para Un Nino Del Programa NC KIDS
DSS-5304: Legal Risk Placement Agreement
DSS-5305: Purchase of Adoption Services Agreement
DSS-5306: Adoption Assistance Suspension Notice
DSS-5307: Adoption Assistance Agreement Amendment
DSS-5308: Adoption Assistance Termination Notice
DSS-5309: Excused Absence Log (For Unpaid Activities)
DSS-5310: Model Court Report for Dispositional and Review Hearings
DSS-5311: Model Court Report for Permanency Planning Hearings
DSS-5312: Model Court Report for Post Termination of Parental Rights Hearings
DSS-5313: Work Registration Indicator
DSS-5313sp: Registro para Trabajar
DSS-5314: Sample Letter for Annual Adoptions Assistance Eligibility Review
DSS-5315sp: Plan de Emancipación de Custodia en Cuidado Foster
DSS-5316: Relative Interest Form
DSS-5317: Relative Notification Letter
DSS-5318: Relative Search Information
DSS-5320: DSS – Monthly Adoption Reporting Form
DSS-5320a: Contract Agency – Monthly Adoption Reporting & Payment Form
DSS-5321: Workers Compensation Fraud in North Carolina
DSS-5321sp: Compensacion De Trabajadores en Carolina Del Norte
DSS-5322: Report of Injuries to Work First Participants in Work Experience/Community Service
DSS-5324: Adoptive Placement Agreement
DSS-5325: Substance Use Behavioral Indicator Checklist II
DSS-5325sp: Lista II De Indicadores De Conducta Por Abuso De Sustancias
DSS-5326: Teen Pregnancy Prevention and Healthy Marriage Initiatives Fact Sheet
DSS-5326sp: Volante Informativo Iniciativas Para La Prevencion Del Embarazo En Adolescentes Y Matrimonios Saludables
DSS-5327: Learning Needs Screening Tool
DSS-5328: Request to Cancel Direct Deposit
DSS-5328sp: Solicitud de Cancelación de Depósito Directo
DSS-5329: Complaint Procedures for the Work First Program
DSS-5329sp: Procedimiento de Queja del Programa Work First
DSS-5330: Learning Needs Screening Tool Waiver & Consent Agreement
DSS-5330sp: Rechazo al Uso de la Herramienta de Detección de Necesidades en el Aprendizaje y Forma de Consentimiento
DSS-5331: ICPC Supervision Report – 30 Days
DSS-5332: ICPC Supervision Report – 90 Days
DSS-5333: Americans with Disabilities Act – Did you know?
DSS-5333sp: ¿Sabía usted?
DSS-5334: Notice of Requirement to Cooperate and Right to Claim Good Cause for Refusal to Cooperate in Child Support Enforcement
DSS-5334sp: Aviso De Requerimiento De Cooperar Y Derecho Para Reclamar (Claim) Una Causa Justificada Para Reusarse A Cooperar Con El Programa De Manutencion Infantil (Child Support Enforcement)
DSS-5335: Consent to Explore American Indian Heritage
DSS-5336: Fostering Connections/Tribal Relative Search (DSS-5336) Instructions
DSS-5339: CPS Expansion (TANF Transfer to SSBG) Eligibility Documentation Form
DSS-5340: TANF Federal Time Clock Verification Request
DSS-5340sp: Peticion De Verificacion Del Reloj Federal Del Programa TANF
DSS-5401 Consent Form for a Clinical Assessment of Protective Parenting (CAPP)
DSS-5402: Child Welfare Human Trafficking Screening Tool
DSS-5758: Supplemental Board Payment for HIV Positive Foster Children Request for Reimbursement
DSS-5759: Request for Supplemental Adoption Assistance for HIV Positive Adopted Children
DSS-5760 Verification of Custody Letter
DSS-5800: Unlicensed Kinship Payment Eligibility Checklist
DSS-5801: Unlicensed Kinship Form-Facility ID Request
DSS-5802: Unlicensed Kinship Acknowledgment
DSS-5960: Law Enforcement and District Attorney Notification
DSS-6187: Application for State Maternity Funds (Voucher, Social History & Service Plan) Problem Pregnancy Services
DSS-6187I: Instructions for Completing Application for State Maternity Fund DSS-6187
DSS-6187sp: Solicitud Para Fondos Estatales Para Maternidad
DSS-6188: Notice of Action on Request for State Maternity Home Funds
DSS-6189: State Maternity Fund Residential Care Provider Agreement
DSS-6190 Rapid Response Team Referral Form
DSS-6191 Plan of Safe Care State Form
DSS-6191sp Formulario de plan de cuidado seguro
DSS-6192: Safe Surrender Health and Information Form
DSS-6195A: Trauma Screening Tool 0-5
DSS-6195B: Trauma Screening Tool 6-21
DSS-6211: State Abortion Fund Eligibility Certification
DSS-6226: NC Division of Vocational Rehabilitation Services and County Social Services Agency/Department Referral
DSS-6226sp: División de Servicios de Rehabilitación Vocacional y Agencia de Servicios Sociales del Condado/ Referencia Departamental
DSS-6228: د مسلکي مهارتونو روزنه او د مهارتونو د بیا تصدیق پلان
DSS-6228: MPANGO WA MAFUNZO YA UJUZI WA UFUNDI NA UTHIBITISHAJI WA UJUZI
DSS-6228: NC Amahugurwa yimyuga nubumenyi Gahunda yo Kwemeza
DSS-6228: NC Vocational Skills Training and Skills Recertifiation Plan (DSS-6228)
DSS-6228: NC የሙያ ክህሎት ስልጠና እና ክህሎት ዳግም ማረጋገጫ እቅድ
DSS-6228: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА ПЛАН ПРОФЕСІЙНО-ТЕХНІЧНОЇ ПІДГОТОВКИ ТА ПЕРЕАТЕСТАЦІЇ
DSS-6228: آموزش مهارت های حرفه ای NC و طرح تایید مجدد مهارت ها
DSS-6228sp: Plan De Recertification Vocacional De Destrezas Y Capacitacion De Destrezas De NC
DSS-6229: MAFUNZO YA UJUZI WA UFUNDI NA UTHIBITISHAJI UPYA WA UJUZI MASHRTI YA MPANGO WA UTEKELEZAJI
DSS-6229: NC Amahugurwa Yimyuga Yumwuga Nubuhanga bwo Kwemeza Amasezerano Yibisabwa
DSS-6229: NC Vocational Skills Training And Skills Recertification Agreement Plan of Action Requirements (DSS-6229)
DSS-6229: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА УГОДА ПРО ПРОФЕСІЙНО-ТЕХНІЧНУ ПІДГОТОВКУ ТА ПЕРЕАТЕСТАЦІЮ ВИМОГИ ДО ПЛАНУ ДІЙ
DSS-6229: الزامات برنامه اقدام برای آموزش مهارت های حرفه ای NC و گواهینامه مجدد مهارت ها
DSS-6229: د مسلکي مهارتونو روزنه او د مهارتونو د بیا تصدیقولو هوکړه لیکد عمل د پلان شراېط
DSS-6229: የኤንሲ የሙያ ክህሎት ስልጠና እና የችሎታ ማረጋገጫ ስምምነት የድርጊት መስፈርቶች እቅድ
dss-6229sp: Acuerdo De Los Requerimientos Del Plan De Accion Del Programa De Evaluacion Y Rercertificacion De Destrezas De NC
DSS-6230 (pt. A): Gahunda yo Kwihaza mu Muryango
DSS-6230 (pt. A): طرح خودکفایی خانواده
DSS-6230 (pt. A): የቤተሰብ ራስን መቻል እቅድ
DSS-6230 (pt. B): Gahunda yo Kwihaza mu Muryango
DSS-6230 (pt. B): طرح خودکفایی خانواده
DSS-6230 (pt. B): የቤተሰብ ራስን መቻል እቅድ
DSS-6230 Part A: MPANGO WA KUJITOSHELEZA KWA FAMILIA SEHEMU A
DSS-6230 Part A: План сімейного самозабезпечення
DSS-6230 Part A: د کورنۍ په ځان بساېنې پلان
DSS-6230 Part B: MPANGO WA KUJITOSHELEZA KWA FAMILIA SEHEMU B
DSS-6230 Part B: План сімейного самозабезпечення
DSS-6230 Part B: کورنۍ په ځان بساېنې پلان
DSS-6230A: Family Self-Sufficiency Plan
DSS-6230B: Family Self Sufficiency Plan
DSS-6230sp: Plan De Autosuficiencia Familiar
DSS-6231: Gahunda ya serivisi ya Leta ishinzwe impunzi
DSS-6231: MPANGO WA HUDUMA
DSS-6231: NC State Refugee Office Service Plan
DSS-6231: NC የስቴት የስደተኞች ቢሮ አገልግሎት እቅድ
DSS-6231: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА ПЛАН НАДАННЯ ПОСЛУГ
DSS-6231: د کډوالو د دفتر د خدمتونو پلان
DSS-6231: طرح خدمات اداره پناهندگان ایالتی NC
DSS-6231sp: Plan Para Establecer Metas
DSS-6232: MPANGO WA UWEZO WA KUAJIRIWA
DSS-6232: NC Gahunda yo Guha akazi Ibiro bya Leta
DSS-6232: NC State Refugee Office Employability Plan
DSS-6232: NC የስቴት የስደተኞች ቢሮ የቅጥር እቅድ
DSS-6232: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА ПЛАН ПРАЦЕВЛАШТУВАННЯ
DSS-6232: د استخدام د وړتیا پلان
DSS-6232: طرح استخدامی اداره پناهندگان ایالتی NC
DSS-6232sp: Programa De Carolina Del Norte Para Asistencia A Refugiados Plan Para Determinar Si La Persona Esta En Condiciones Para Ser Empleada
DSS-6233: Client (ELT) Service Plan
DSS-6233: Gahunda ya serivisi y’abakiriya (ELT)
DSS-6233: MAFUNZO YA LUGHA YA KIINGEREZA
DSS-6233: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА ПЛАН ВИВЧЕННЯ АНГЛІЙСЬКОЇ МОВИ
DSS-6233: د پیرودونکي (ELT) خدمت پلان
DSS-6233: طرح خدمات مشتری (ELT).
DSS-6233: የደንበኛ (ELT) የአገልግሎት እቅድ
DSS-6233sp: Plan De Servicio (ELT) Al Cliente
DSS-6234: ELT Learner Initial Assessment Form
DSS-6234: ELT Yiga Ifishi Yambere Yisuzuma
DSS-6234: MAFUNZO YA LUGHA YA KIINGEREZA FOMU YA MTIHANI WA KWANZA
DSS-6234: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА НАВЧАННЯ АНГЛІЙСЬКОЇ МОВИ ФОРМА ПОЧАТКОВОГО ОЦІНЮВАННЯ
DSS-6234: د لومړنۍ ارزونې فورمه
DSS-6234: فرم ارزیابی اولیه زبان آموزان ELT
DSS-6234: የELT ተማሪ የመጀመሪያ ግምገማ ቅጽ
DSS-6234sp: Formulario De Evaluacion Inicial Del Estudiante ELT
DSS-6235: Case Review Form
DSS-6235: FOMU YA UKAGUZI WA MPANGO
DSS-6235: Ifishi yo gusuzuma
DSS-6235: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА ФОРМА ПЕРЕГЛЯДУ СПРАВИ
DSS-6235: د قضیې د بیاکتنې فورمه
DSS-6235: فرم بررسی پرونده
DSS-6235: የጉዳይ ግምገማ ቅጽ
DSS-6235sp: Revision Trimestral
DSS-6236: Idhini ya Ufahamu ya Kutolewa kwa Maelezo
DSS-6236: Informed Consent For Release Of Information
DSS-6236: Kumenyeshwa Kumenyekanisha Kurekura Amakuru
DSS-6236: управління у справах біженців штату північна кароліна Інформована згода на розкриття інформації
DSS-6236: د مالوماتو خپرولو لپاره آګاهانه رضایت
DSS-6236: رضایت آگاهانه برای انتشار اطلاعات
DSS-6236: መረጃን ለመልቀቅ በመረጃ የተደገፈ ስምምነት
DSS-6236sp: Consentimiento Con Conocimiento De Causa Para Divulgación De Información
DSS-6237: DSS Refugee Client Rights Form
DSS-6237: FOMU IKUBIYEMO UBURENGANZIRA BW’UMUKIRIYA
DSS-6237: FOMU YA HAKI ZA MTEJA
DSS-6237: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА ФОРМА ПРАВ КЛІЄНТА
DSS-6237: د مهاجرینو د مراجعینو د حقونو فورمه
DSS-6237: فرم حقوق مشتری پناهندگان DSS
DSS-6237: የDSS የስደተኞች ደንበኛ መብቶች ቅጽ
DSS-6237sp: Formulario De Derechos Del Cliente De Carolina De Norte
DSS-6238: Refugee Cash Assistance Eligibility Monitoring Guide
DSS-6239A: Amasezerano yo Guhana Impunzi
DSS-6239A: MAKUBALIANO YA UWAJIBIKAJI WA PAMOJA WA WAKIMBIZI
DSS-6239A: Refugee Mutual Responsibility Agreement
DSS-6239A: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА УГОДА З БІЖЕНЦЯМИ ПРО ВЗАЄМНУ ВІДПОВІДАЛЬНІСТЬ
DSS-6239A: د کډوالو د دوه اړخیز مسؤلیت تړون
DSS-6239A: موافقتنامه مسئولیت متقابل پناهندگان
DSS-6239A: የስደተኞች የጋራ ኃላፊነት ስምምነት
DSS-6239B: Impunzi MRA Gahunda y’ibisabwa
DSS-6239B: MASHARTI YA MPANGO WA UTEKELEZAJI
DSS-6239B: Refugee MRA Plan of Action Requirements
DSS-6239B: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА УГОДА ПРО ВЗАЄМНУ ВІДПОВІДАЛЬНІСТЬ
DSS-6239B: الزامات برنامه اقدام MRA پناهندگان
DSS-6239B: د مهاجرینو MRA د عمل اړتیاو پلان
DSS-6239B: የስደተኛ MRA የድርጊት መስፈርቶች እቅድ
DSS-6240_AR: (SNAP) طلب الاشتراك في برنامج المعونة الغذائية المُبسط
DSS-6240_DE: Antrag Auf Vereinfachtes Programm Fur Lebensmittelhilfe (SNAP)
DSS-6240_KO: 간이 영양 지원 프로그램(SNAP) 신청서
DSS-6240: Simplified Nutritional Assistance Program (SNAP) Application
DSS-6240A_AR: احفظ هذه الصفحة في سجلاتك
DSS-6240A_DE: Legen Sie diese Seite bitte zu Ihren Unterlagen
DSS-6240A_FR: Programme Simplifie D’Aide Nutritionnelle (SNAP)
DSS-6240A_KO: 참조를 위해 이 문서를 보관하십시오
DSS-6240A_VI: Thông Tin Chương Trình Và Các Quyền Và Trách Nhiệm Của Bạn
DSS-6240Asp: Programa Simplificado De Asistencia Nutricional Información sobre el programa. Derechos y Responsabilidades
DSS-6240sp: Solicitud Del Programa Simplificado De Asistencia Nutricional (Simplified Nutritional Assistance Program, SNAP)
DSS-6241: Refugee Cash Assistance (RCA) Application
DSS-6241sp: Solicitud de Asistencia en Efectivo para Refugiados (RCA)
DSS-6242: Refugee Medical Assistance (RMA) Application
DSS-6242sp: Solicitud de Asistencia Médica para Refugiados (RMA)
DSS-6246: Affidavit of Paternity
DSS-6247: Notification of Refugee Arrival and Intent to Apply for Benefits
DSS-6250: Gahunda ya Serivisi ishinzwe amategeko
DSS-6250: Legal Service Plan
DSS-6250: MPANGO WA HUDUMA YA KISHERIA
DSS-6250: УПРАВЛІННЯ У СПРАВАХ БІЖЕНЦІВ ШТАТУ ПІВНІЧНА КАРОЛІНА ПЛАН НАДАННЯ ЮРИДИЧНИХ ПОСЛУГ
DSS-6250: د حقوقي خدماتو پلان
DSS-6250: طرح خدمات حقوقی
DSS-6250: የህግ አገልግሎት እቅድ
DSS-6852: Authorization / Receipt for Direct Payment
DSS-6901: Work First Employment Services Assessment Form
DSS-6902: Screening for Child Well Being
DSS-6902sp: Evaluacion De Bienestar De Menores
DSS-6904: Work First Information Transmittal
DSS-6905: Work Experience/Community Service Agreement
DSS-6905sp: Sericios De Empleo Work First Acuerdo de Experiencia Laboral y Servicio Comunitario
DSS-6960: Job Search/Verification Log
DSS-6960sp: Busqueda De Trabajo y Registro De Verificaion
DSS-6961: Verification of Household Composition
DSS-6961sp: La Verificacion De La Composicion Del Grupo Familiar
DSS-6962: Workers Compensation Guide for Work First Participants In Work Experience and Community Service Activities
DSS-6962sp: Guía de Compensación Para Trabajadores Participantes en los Programas de Work Experience (Experiencia de Trabajo) y Servicio Comunitario
DSS-6963a_bsp: Acuerdo De Responsbilidad Mutua Requerimientos Basicos
DSS-6963a: Mutual Responsibility Agreement – Core Requirements
DSS-6963Asp: Acuerdo De Responsabilidad Mutua – Requerimientos Basicos
DSS-6963b: Mutual Responsibility Agreement Plan of Action Requirements
DSS-6963Bsp: Acuerdo De Responsabilidad Mutua Requisitos Del Plan Accion
DSS-6963c: Mutual Responsibility Agreement Plan of Action Requirements for Work First Services
DSS-6964: Program Reference Guide
DSS-6964sp: Informacion de Programas
DSS-6965: Family Violence Option/Domestic Violence Work First Assessment
DSS-6965sp: Opcion Respecto a Violencia Familiar/Violencia Domestica Evaluacion Work First
DSS-6966: Notification of Family Violence Option
DSS-6966sp: Notificación de opción de violencia familiar
DSS-6967: Family Violence Option Brochure
DSS-6968: Screening for Domestic Violence
DSS-6968sp: Preguntas de Violencia Doméstica
DSS-6969: Consent for Release of Information
DSS-6969sp: Consentimiento Para Proporcionar Informacion
DSS-8104: Second Notice of Right to Claim Good Cause for Refusal to Cooperate in Child Support Enforcement
DSS-8104sp: Segundo Aviso De Derecho A Presentar Buena Razon Para Negarse A Cooperar Con El Cumplimiento De La Manutencion Infantil
DSS-8105A Programa De Asistencia De Agua-Aviso De Aprobacion
DSS-8105A Water Assistance Program-Notice of Approval
DSS-8105A СПОВІЩЕННЯ ПРО СХВАЛЕННЯ ПРОГРАМИ ДОПОМОГИ З ВОДОПОСТАЧАННЯМ
DSS-8105A: СПОВІЩЕННЯ ПРО СХВАЛЕННЯ ПРОГРАМИ ДОПОМОГИ З ВОДОПОСТАЧАННЯМ
DSS-8105B Programa De Asistencia De Agua-Aviso De Negacion
DSS-8105B Water Assistance Program-Notice of Denial
DSS-8105B: ПРОГРАМИ ДОПОМОГИ З ВОДОПОСТАЧАННЯМ – СПОВІЩЕННЯ ПРО ВІДХИЛЕННЯ
DSS-8105B: ПРОГРАММА ПОМОЩИ В ОПЛАТЕ ВОДОСНАБЖЕНИЯ — УВЕДОМЛЕНИЕ ОБ ОТКАЗЕ
DSS-8105C Programa De Asistencia De Agua-Aviso De Solicitud Retirada
DSS-8105C Water Assistance Program-Notice of Withdrawal
DSS-8105C: ПРОГРАМИ ДОПОМОГИ З ВОДОПОСТАЧАННЯМ – СПОВІЩЕННЯ ПРО ВІДКЛИКАННЯ
DSS-8105C: ПРОГРАММА ПОМОЩИ В ОПЛАТЕ ВОДОСНАБЖЕНИЯ — УВЕДОМЛЕНИЕ ОБ ОТЗЫВЕ
DSS-8107_AR: إخطار الموافقة/الرفض برامج الطاقة
DSS-8107_DE: Energie Programme Mitteilung Uber Genehmigung/Ablehnung
DSS-8107_FR: Programmes Lies A L’Energie Notifcation D’Approbation/De Refus
DSS-8107_KO: 에너지 프로그램 승인/거부 고지
DSS-8107_VI: CHƯƠNG TRÌNH NĂNG LƯỢNG THÔNG BÁO VỀ PHÊ DUYỆT/TỪ CHỐI
DSS-8107-ia: СПОВІЩЕННЯ ПРО СХВАЛЕННЯ/ВІДХИЛЕННЯ УЧАСТІ В ЕНЕРГЕТИЧНИХ ПРОГРАМАХ
DSS-8107-ia: УЧАСТИЕ В ПРОГРАММАХ ПОМОЩИ В СФЕРЕ ЭНЕРГОСНАБЖЕНИЯ — УВЕДОМЛЕНИЕ ОБ УТВЕРЖДЕНИИ/ОТКАЗЕ
DSS-8107: Energy Programs Notice of Approval/Denial
DSS-8107b: Energy Programs Action Notice
DSS-8107bsp: Programas De Energia Aviso De Accion
DSS-8107D_sp: Aviso De Aprobacion/Denegacion En La Programa De Asistencia De Energia En Casos De Desastre (DEAP)
DSS-8107D_sp: Disaster Energy Assistance Notice of Approval/Denial
DSS-8107sp: Programas De Asistencia De Energia Aviso De Aprobacion/Denegacion
DSS-8108: Notice of Benefits
DSS-8108sp: Aviso De Beneficios
DSS-8109: Votre demande de prestations est refusée ou retirée
DSS-8109: Your Application for Benefits is Being Denied or Withdrawn
DSS-8109sp: Su Solicitud De Beneficios Ha Sido Rechazada O Retirada
DSS-8110: Notice of Modification, Termination, or Continuation of Public Assistance
DSS-8110sp: Aviso de Modificación, Terminación, o Continuación de Asistencia Pública
DSS-8113_DE: Gehaltsbestatigungsformular
DSS-8113_FR: Formulaire De Verification Des Salaires
DSS-8113: Wage Verification Form
DSS-8113sp: Formulario de Verificacin de Sueldo
DSS-8115: LIEAP Denial Notice
DSS-8115sp: Programa De Asistencia De Energia Para Personas De Escasos Recursos Aviso De Denegacion
DSS-8116I: Low Income Energy Assistance Program Eligibility Worksheet
DSS-8116Isp: Programa De Asistencia De Energia Por Bajos Ingresos Hoja De Trabajo Para Determinar La Elegibidad
DSS-8117: North Carolina’s Energy Programs Brochure
DSS-8117: ЕНЕРГЕТИЧНІ ПРОГРАМИ ПІВНІЧНОЇ КАРОЛІНИ
DSS-8117: ПРОГРАММЫ ПОМОЩИ В СФЕРЕ ЭНЕРГОСНАБЖЕНИЯ, NORTH CAROLINA
DSS-8117sp: Programas De Asistencia De Energia De Carolina Del Norte
DSS-8118: Certification Utilities Moratorium
DSS-8118sp: Moratoria De Certificacion De Servicios Publicos
DSS-8119: Energy Programs Outreach Plan
DSS-8124: Application for Work First Family Assistance, MA, Refugee, and SA
DSS-8124a: EIS Application for Work First Family Assistance, MA, Refugee, and SA
DSS-8124Asp: Application for Work First Family Assistance, MA, Refugee, and SA
DSS-8124b: Rights and Responsibilities
DSS-8124Bsp: ¿Cuáles son mis derechos? ¿Cuáles son mis responsabilidades?
DSS-8127: Work First Family Assistance Report
DSS-8127sp: Informe De Asistencia Familiar Work First
DSS-8129: Request for Replacement Check
DSS-8129sp: Sistema De Informacion Sobre Elegibilidad y Sistema De Seguimiento De Informacion Sobre Acogimiento De Menores
DSS-8131: Change in Situation Report
DSS-8137: Notice of Incomplete Work First Family Assistance Report
DSS-8137sp: Notificacion De Informe Incompleto Del Programa De Asistencia Familiar Work First
DSS-8146A: Notice of Information Needed to Determine Your Eligibility for Work First Family Assistance
DSS-8146Asp: Aviso De Informacion Necesaria Para Determinar Su Elegibilidad Para El Programa Work First
DSS-8162 LIHWAP Agreement
DSS-8162sp LIHWAP Agreement
DSS-8163_FR: Accord Sur L’Approvionnement En Energie Domestique
DSS-8163: Energy Provider Agreement
DSS-8169: Work First Emergency Assistance Application
DSS-8169sp: Solicitud Del Programa Work First (Trabajar Primero) De Emergencia
DSS-8173_AR: بيان إحصاء
DSS-8173_DE: Freistellungserklärung für Auflistung
DSS-8173_FR: Communiqué concernant le recensement
DSS-8173_VI: Công Bố Cho Mục Đích Liệt Kê
DSS-8173: Release For Enumeration
DSS-8173sp: Revelación para enumeración
DSS-8174: Referral for Social Security Number Application
DSS-8176_AR: نموذج المساهمة
DSS-8176_DE: Beitragsformular
DSS-8176_FR: Formulaire De Contribution
DSS-8176_KO: 기증 양식
DSS-8176_VI: MẪU ĐÓNG GÓP
DSS-8176: Contribution Form
DSS-8176sp: Contribution Form (Spanish)
DSS-8178_AR: طلب برامج الطاقة
DSS-8178-ia: ЗАЯВКА НА УЧАСТИЕ В ПРОГРАММЕ ПОМОЩИ В СФЕРЕ ЭНЕРГОСНАБЖЕНИЯ
DSS-8178-ia: ЗАЯВКА НА УЧАСТЬ В ЕНЕРГЕТИЧНИХ ПРОГРАМАХ
DSS-8178: Energy Programs Application
DSS-8178A: Crisis Intervention Program Worksheet
DSS-8178Asp: Hoja De Trabajo De Intervencion De Crisis
DSS-8178D_sp: Programa De Asistencia De Energia En Casos De Desastre (DEAP)
DSS-8178D: Energy Disaster Funds Application
DSS-8178L: Low Income Energy Assistance Program Application (LIEAP)
DSS-8178Lsp: Solicitud Para El Programa De Asistencia De Energia Para Personas De Bajos Ingresos
DSS-8178sp: Solicitud Para Programas De Ayuda Para Energia
DSS-8178W: Solicitud Del Programa De Asistencia De Agua Para Familias De Bajos Ingresos (LIHWAP)
DSS-8185-ia: Програма допомоги в енергетичній сфері для сімей із низьким доходом / програма кризового втручання
DSS-8185-ia: Программа помощи семьям с низким доходом в оплате энергоснабжения Программа кризисного вмешательства
DSS-8185: Low Income Energy Assistance Program Crisis Intervention Program Information Needed
DSS-8185A: Prepare for the Energy Program Application Interview
DSS-8185Asp: Prepárese para la entrevista de la solicitud del Programa de Energía
DSS-8185sp: Programa de Asistencia de Energía para Personas de Bajos Ingresos Programa de Intervención en Crisis Se Necesita La Siguiente Informacion
DSS-8189: Appointment Notice
DSS-8189sp: Aviso De Cita
DSS-8190 SSI/Non-SSI Application Workbook
DSS-8190A SSI/Non-SSI Application Workbook Appendix A
DSS-8191 Special Assistance Re-enrollment Information Notice
DSS-8191i: Work First / Medicaid Notice of Inquiry
DSS-8191w: Work First / Medicaid Notice of Withdrawal
DSS-8191wsp: Aiso De Retiro De Work First / Medicaid
DSS-8194: Income Maintenance Transmittal Form
DSS-8196: Special Announcement Letter
DSS-8197: Change in Caseworker Letter
DSS-8200: Third Party Query Request
DSS-8201: County Responsible Overpayment
DSS-8205_AR: خطاب مصادقة مالك العقار
DSS-8205_DE: Bestätigungsschreiben Vermieter
DSS-8205_FR: Attestation du propriétaire
DSS-8205_KO: 임대자 확인서
DSS-8205_VI: Thư Xác Nhận Của Chủ Nhà
DSS-8205: Landlord Verification Letter
DSS-8205sp: Carta de verificación del propietario
DSS-8207_AR: طلب الاشتراك في برنامج خدمات الطعام والتغذية
DSS-8207_DE: Antrag auf Lebensmittelleistungen
DSS-8207_FR: Demande de Services d’alimentation et de nutrition (Food and Nutrition Services)
DSS-8207_KO: 식품 및 영양 서비스 신청서
DSS-8207_VI: Đơn Đăng Ký Dịch Vụ Dinh Dưỡng Và Thực Phẩm (Food and Nutrition Services)
DSS-8207: Application for Food and Nutrition Services
DSS-8207A_AR: معلومات البرنامج والحقوق والمسؤوليات
DSS-8207A_DE: Programminformationen und Rechte und Verantwortungen
DSS-8207A_FR: Informations sur le Programme et les Droits et Responsabilités
DSS-8207A_KO: 프로그램 정보 및 권리와 의무
DSS-8207A_VI: Thông Tin Chương Trình, Các Quyền và Trách Nhiệm
DSS-8207sp: Solicitud de Beneficios del Programa de Servicios de Alimentos y Nutrición
DSS-8207ssi_AR: قسم الخدمات الاجتماعية الإقليمي
DSS-8207ssi_DE: Zusätzliche Sozialleistungen/Lebensmittel-leistungen Antrag
DSS-8207ssi_FR: Demande de Services d’alimentation et de nutrition/Revenu de sécurité supplémentaire (SSI)
DSS-8207ssi_KO: SSI/식품 및 영양 서비스 신청서
DSS-8207ssi_VI: SSI/Dịch Vụ Dinh Dưỡng và Thực Phẩm Đơn Xin
DSS-8207ssi: SSI/Food Stamp Application
DSS-8208: Medical Deduction Supplement
DSS-8209: FNS Medical Report Form
DSS-8209sp: Formulario de informe médico de servicios de alimentación y nutrición
DSS-8214: Emotional Health Inventory – 13 Item Version РAdministration Guide
DSS-8215: Substance Use Information
DSS-8215sp: Informacion sobre Uso de Sustancias
DSS-8216: Frequently Asked Questions about Electronic Benefit Issuance
DSS-8216sp: Preguntas Frecuentes acerca de Expedicion Electronica de Beneficios
DSS-8217_AR: برنامج خدمات الطعام والتغذية الإقليمي
DSS-8217_DE: Elektronische Überweisung der Leistungen Antrag auf Kontobelastung
DSS-8217_FR: Transfert électronique de prestation Demande de débit de compte
DSS-8217_KO: 전자 수당 지급 계좌 직불카드 요청
DSS-8217_VI: Chuyển Khoản Phúc Lợi Bằng Điện Tử Yêu Cầu Ghi Nợ Tài Khoản
DSS-8217: Electronic Benefit Transfer Account Debit Request
DSS-8217sp: Transferencia electrónica de beneficios Solicitud de débito de cuenta
DSS-8218: Alcohol Use Disorders Identification Test (Audit)
DSS-8218A: Work First Program Substance Use Screening Notice
DSS-8218Asp: Aviso De Evaluacion De Uso De Sustancias De Work First (Trabajar Primero)
DSS-8218B: Work First Program Testing Notice
DSS-8218Bsp: Aviso de Prueba del Programa Work First (Trabajar Primero)
DSS-8218sp: Prueba De Identificacion De Desordenes En El Uso De Alcohol (Audit)
DSS-8219: Consent For Release of Confidential Information
DSS-8219sp: Consentimiento Para Proporcionar Informacion Confidencial
DSS-8220A: Timely Notice of Pending Termination 22 Months
DSS-8220Asp: Aviso Anticipado De Proxima Suspension Asistencia En Efectivo Work First
DSS-8220b: Timely Notice of Pending Termination 58 Months
DSS-8220Bsp: Aviso Anticipado De Proxima Suspension Asistencia En Efectivo Work First
DSS-8220c: Timely Notice of Pending Termination Work First Family Assistance
DSS-8220csp: Aviso Anticipado De Teminacion Pendiente Programa De Asistencia Familiar Work First (Trabajar Primero)
DSS-8221: What Happens If You Can’t Meet Your Work Requirements Because Appropriate Child Care is Not Available?
DSS-8221sp: ¿Que Pasa Si No Puede Satisfacer Sus Requisitos De Trabajo Porque No Tiene Cuidado Infantil Adecuado?
DSS-8222: Notice of Work First Family Assistance Job Bonus
DSS-8222sp: Programa de Asistencia Familiar Work First. Bonificación por Trabajo
DSS-8223: Substance Use Referral Log
DSS-8224: Work First Program Referral to Qualified Professional in Substance Abuse
DSS-8224sp: Programa Work First (Trabajar Primero) Persona Referida A Un Profesional Calificado En Abuso De Susutancias
DSS-8225: Eligibility Worksheet
DSS-8225sp: Hoja De Trabajo De Elegibilidad
DSS-8226: Letter of Overpayment
DSS-8226sp: Carta De Pago Excesivo
DSS-8227: Important Information You Need to Know
DSS-8227: Informations importantes que vous devez savoir
DSS-8227: ВАЖЛИВА ІНФОРМАЦІЯ, ЯКУ ВАМ НЕОБХІДНО ЗНАТИ
DSS-8227sp: Noticia Del Acceso A Beneficios Para Immigrantes
DSS-8228: Work First Cash Assistance Application and Review Documentation Workbook
DSS-8228sp: Solicitud para Asistencia Monetaria del Programa Work First (Trabajar Primero) y Revisión de Documentación Necesaria
DSS-8230_AR: إخطار بتحديد موعد سلامة البرنامج
DSS-8230_DE: Mitteilung Uber Termin Zu Programmintegritat
DSS-8230_FR: Notification De Rendez-vous D’Integrite Vis-À-Vis Du Programme
DSS-8230_KO: 프로그램 준수 심사 일정 통지
DSS-8230_VI: THÔNG BÁO BUỔI HẸN SỰ LIÊM CHÍNH TRONG CHƯƠNG TRÌNH
DSS-8230: Program Integrity Appointment Notice
DSS-8230sp: Aviso De Cita De Integridad De Programa
DSS-8231_AR: طلب معلومات
DSS-8231_DE: Anforderung Von Informationen
DSS-8231_FR: Demande D’Informations
DSS-8231_KO: 정보 요청
DSS-8231_VI: YÊU CẦU THÔNG TIN
DSS-8231: Request for Information
DSS-8231sp: Solicitud De Informacion
DSS-8232_AR: قسم الخدمات الاجتماعية بولاية كارولاينا الشمالية
DSS-8232_DE: Vereinfachtes Programm Fur Lebensmittelhife (SNAP)
DSS-8232_KO: 간이 영양 지원 프로그램(SNAP) 만기일 통지
DSS-8232: Simplified Nutritional Assistance Program (SNAP) Notice of Expiration
DSS-8232sp: Programa Simplificado De Asistencia Nutricional (Simplified Nutritional Assistance Program, SNAP) Aviso De Expiracion
DSS-8234: NCEL Notice to Debtor
DSS-8234sp: NC Education Lottery Collection Notice Letter (Spanish Version)
DSS-8239: Alien Worksheet
DSS-8240_AR: إجراءات تقديم شكوى بخصوص برنامج خدمات الطعام والتغذية
DSS-8240_DE: Beschwerdevergahren Fur Lebensmittelleistungen
DSS-8240_FR: Procedures De Reclamation Des Services D’Alimentation Et De Nutrition
DSS-8240_KO: 식품 및 영양 서비스 불만 제기 절차
DSS-8240_VI: KHIẾU NẠI DỊCH VỤ DINH DƯỠNG VÀ THỰC PHẨM
DSS-8240: Food and Nutrition Services Complaint Procedures
DSS-8240sp: Programa De Servicios De Alimentos Y Nutricion Procedimiento De Quejas
DSS-8550_AR: نموذج الإبلاغ عن التغييرات
DSS-8550_DE: Formular Fur Meldung Von Anderungen
DSS-8550_FR: Formulaire De Declaration De Changement
DSS-8550_KO: 변경 보고서 양식
DSS-8550_VI: MẪU BÁO CÁO THAY ĐỔI
DSS-8550: Change Report Form
DSS-8550sp: Formulario De Informe De Cambios
DSS-8550srsp: Formulario Para Reportar Cambios Para El Informe Semestral De Hogares
DSS-8551_AR: إخطار الأهلية، أو الرفض أو الحالة المعلقة
DSS-8551_DE: Mitteilung Uber Anspruchsberechtigung, Ablehnung Oder Schwebenden Status
DSS-8551_FR: Notification Du Statut D’Eligibilite. Refus Ou En Suspens
DSS-8551_KO: 자격, 거부 또는 계류 상태의 고지
DSS-8551_VI: THÔNG BÁO VỀ SỰ HỘI ĐỦ ĐIỀU KIỆN, TỪ CHỐI HOẶC TÌNH TRẠNG ĐANG CHỜ
DSS-8551: Notice of Eligibility, Denial, or Pending Status
DSS-8551sp: Aviso De Elegibilidad, Denegacion O Estado Pendiente
DSS-8552: Food and Nutrition Services Makes North Carolina Stronger
DSS-8552sp: El Programa de Servicios de Alimentos y Nutrición hace a Carolina del Norte más Fuerte
DSS-8553_AR: قسم الخدمات الاجتماعية إخطار بإجراء مضاد
DSS-8553_DE: Mitteilung Uber Nachteilige Schritte
DSS-8553_FR: Notification D’Action Defavorable
DSS-8553_KO: 혜택 변경 통지서
DSS-8553_VI: THÔNG BÁO VỀ HÀNH ĐỘNG BẤT LỢI
DSS-8553: Notice of Adverse Action
DSS-8553sp: Aviso De Medida Adversa
DSS-8554_AR: قسم الخدمات الاجتماعية خطاب الدفعة الزائدة
DSS-8554_DE: Schreiben Uber Uberbezahlung
DSS-8554_FR: Lettre Concernant Une Emission Excedentaire Ou Trop-Percu
DSS-8554_KO: 초과 지급 통지서
DSS-8554_VI: THƯ THÔNG BÁO PHÁT QUÁ
DSS-8554: NC DHHS DSS Letter of Overissuance
DSS-8554sp: Carta De Notificacion De Pago Excesivo
DSS-8555: Food and Nutrition Services First Month of Overissuance Determination Semi-Annual Reporting Cases
DSS-8556_AR: إخطار مُسبق بجلسة الاستماع المتعلقة بعدم الأهلية
DSS-8556_DE: Vorankundigung Uber Disqualifikationsanhorung
DSS-8556_FR: Notification Prealable D’Audition Pour Exclusion
DSS-8556_VI: THÔNG BÁO TRƯỚC VỀ BUỔI ĐIỀU TRẦN TRUẤT QUYỀN
DSS-8556: Advance Notice of Disqualification Hearing
DSS-8556sp: Aviso Por Adelantado De Audiencia De Descalificacion
DSS-8557_AR: إخطار بقرار جلسة استماع عدم الأهلية في الولاية
DSS-8557_DE: Mitteilung Uber Entsheidung Der Bundesstaatlichen Disqualifikationsanhorung
DSS-8557_FR: Notification D’une Decision D’Exclusion Par L’Etat A La Suite D’une Audition
DSS-8557_KO: 주 정부 자격상실 심리 결정 고지
DSS-8557_VI: THÔNG BÁO VỀ QUYẾT ĐỊNH TRONG PHIÊN XỬ TRUẤT QUYỀN CỦA TIỂU BANG
DSS-8557: Notice of State Disqualificaiton Hearing Decision
DSS-8557sp: Decision De Audiencia: Aviso De Descalificacion Estatal
DSS-8558_AR: الإجراء المتخذ بشأن جلسة استماع عدم الأهلية الإدارية
DSS-8558_DE: Ergriffene Massnahme Bezuglich Administrativer Disqualifikationsanhorung
DSS-8558_FR: Action Prise Faisant Suite A Une Audition Concernant Une Exclusion Administrative
DSS-8558_KO: 행정 자격상실 심리에 취해지는 조치
DSS-8558_VI: HÀNH ĐỘNG THỰC HIỆN ĐỐI VỚI BUỔI ĐIỀU TRẦN TRUẤT QUYỀN HÀNH CHÍNH
DSS-8558: Action Taken on Administrative Disqualification Hearing
DSS-8558sp: Renuncia a la Audiencia De Descalificacion
DSS-8560: Caseworker Desk Reference
DSS-8560sp: Referencia Para El Trabajador Del Caso
DSS-8561: Food and Nutrition Services First Month of Overissuance Determination Simplified Reporting Cases
DSS-8562_AR: أثر التغيير
DSS-8562_DE: Auswirkung Der Anderung
DSS-8562_FR: Consequence Du Changement
DSS-8562_KO: 변경의 영향
DSS-8562_VI: TÁC ĐỘNG CỦA THAY ĐỔI
DSS-8562: Effect of Change
DSS-8562sp: Efecto Del Cambio Informado
DSS-8566: FNS First Month of Overissuance Determination Standard and Simplified Cases
DSS-8567: Language Notice
DSS-8568: ABAWD Requirements Form
DSS-8568sp: Forma de Requerimientos para Personas ABAWD
DSS-8569 Consolidated Work Notice
DSS-8569sp Aviso de Trabajo Consolidado
DSS-8584_AR: خطاب الدفعة الزائدة الانتهاك المُتعمد للبرنامج
DSS-8584_DE: Schreiben Uber Uberbezahlung Vorsatzlicher Programmverstoss
DSS-8584_FR: Lettre Concernant Une Émission Excedentaire Suite À Une Violation Intentionnelle Du Programme
DSS-8584_KO: 초과 지급 통지서 고의적인 프로그램 위반
DSS-8584_VI: THƯ VỀ VIỆC PHÁT QUÁ CỐ Ý VI PHẠM CHƯƠNG TRÌNH
DSS-8584: Letter for Overissuance / Intentional Program Violation
DSS-8586_AR: إخطار عدم أهلية
DSS-8586_DE: Mitteilung Uber Disqualifikation
DSS-8586_FR: Avis De Pemalite
DSS-8586_KO: 자격상실 통지서
DSS-8586_VI: THÔNG BÁO TRUẤT QUYỀN
DSS-8586: Notice of Disqualification
DSS-8586sp: Aviso De Descalificacion
DSS-8587_AR: الإجراء المُتخذ عند التنازل عن جلسة استماع عدم الأهلية الإدارية
DSS-8587_DE: Ergriffene Massnahme Bezuglich Verzicht Auf Administrative Disqualifikationsanhorung
DSS-8587_FR: Action Prise Faisant Suite À La Renonciation À Une Audition Concernant Une Exclusion Administrative
DSS-8587_VI: HÀNH ĐỘNG THỰC HIỆN ĐỐI VỚI VIỆC KHƯỚC TỪ BUỔI ĐIỀU TRẦN TRUẤT QUYỀN HÀNH CHÍNH
DSS-8587: Action Taken on Waiver of Administrative Disqualification Hearing
DSS-8587sp: Medidas Tomadas Respecto A La Renumcia A La Audiencia De Descalificacion Administrativa
DSS-8588_AR: جلسة استماع التنازل عن عدم الأهلية
DSS-8588_DE: Verzicht Auf Disqualifikationsanhorung
DSS-8588_FR: Renonciation À L’Audition Concernant Une Exclusion
DSS-8588_KO: 자격상실 심리의 포기
DSS-8588_VI: GIẤY KHƯỚC TỪ BUỔI ĐIỀU TRẦN TRUẤT QUYỀN
DSS-8588: Waiver of Disqualification Hearing
DSS-8588sp: Renuncia A La Audiencia De Descalificacion
DSS-8590: Food and Nutrition Services Client Record
DSS-8593: Food Stamp Benefit Issuance Transactions
DSS-8594_AR: إخطار بالموعد إخطار بانتهاء الصلاحية
DSS-8594_DE: Mitteilung über Ablauf von Leistungen
DSS-8594_FR: Notification d’expiration
DSS-8594_KO: 면담 일정 통지서 만기일 통지
DSS-8594_VI: Thông Báo Hết Hạn
DSS-8594: Appointment Notice-Notice of Expiration
DSS-8594sp: Aviso de Cita, Aviso de Vencimiento
DSS-8600: Important Disaster Food and Nutrition Services Program Information
DSS-8600sp: Informacion Importante Sobre El Programa De Servicios De Alimento y Nutricion Por Desastre
DSS-8601: Food and Nutrition Services Disaster EBT Card Delivery and Receipt
DSS-8602: Food and Nutrition Services Disaster Electronic Benefit Transfer Card Destruction
DSS-8603: Food and Nutrition Services Returned Disaster EBT Card
DSS-8604_AR: اتفاقية سداد الدفعة الزائدة
DSS-8604_DE: Rückzahlungsvereinbarung für Überbezahlung
DSS-8604_FR: Accord de remboursement concernant une émission excédentaire ou trop-perçu
DSS-8604_KO: 초과 지급금 상환 약정
DSS-8604_VI: Thỏa Thuận Hoàn Lại Số Tiền Phát Thừa
DSS-8604: Overissuance Repayment Agreement
DSS-8604sp: Acuerdo de devolución de exceso de pago
DSS-8605_AR: إخطار نية تقديم الدين إلى وزارة الخزينة الأمريكية للتحصيل بالمقاصة
DSS-8605_DE: Mitteilung Uber Absicht, Schulden Zur Eintreibung Durch Verrechnung An Das US-Finanzministerium Zu Überweisen
DSS-8605_FR: Notification De L’Intention De Soumettre Une Dette Au Tresor Americain Pour Recouvrement Par Compensation
DSS-8605_KO: 채무 추심을 위해 미국 재무부에 채무 이첩 의향 통지서
DSS-8605_VI: THÔNG BÁO Ý ĐỊNH CHUYỂN KHOẢN NỢ TỚI BỘ TÀI CHÍNH HOA KỲ ĐỂ HOÀN TRẢ NỢ
DSS-8605: Notice of Intent to Submit Debt to U.S. Treasury for Offset Collection
DSS-8605sp: Aviso De Intento De Presentar Una Deuda A La Tesoreria De Estados Unidos Para Recaudacion Por Retencion
DSS-8606_AR: إخطار بقرار مراجعة برنامج المقاصة التابع لوزارة الخزينة المحلي
DSS-8606_DE: Mitteilung über geprüfte Entscheidung des Verrechnungsprogramm des US-Finanzministeriums
DSS-8606_FR: Notification de décision à la suite de l’examen du TOP local
DSS-8606_KO: 지역 TOP 검토 결정 통지서
DSS-8606_VI: Thông Báo Về Quyết Định Xem Xét của TOP Tại Địa Phương
DSS-8606: Notice of Local TOP Review Decision
DSS-8607_AR: الاسم الأول — الاسم الأخير
DSS-8607_DE: Wir haben vor Kurzem
DSS-8607_FR: Nous avons récemment recouvré
DSS-8607_KO: 당 기관은 최근에 초과 지급된 식품 및 영양 서비스에 대해 귀하에게 청구된
DSS-8607_VI: Gần đây chúng tôi đã
DSS-8607: Refund Notice
DSS-8608_AR: الاسم الأول — الاسم الأخير
DSS-8608_DE: Wir haben vor Kurzem einen Betrag für Ihren Anspruch für zu viel gezahlte Lebensmittelleistungen eingetrieben
DSS-8608_FR: Nous avons récemment recouvré et appliqué un montant relatif à la réclamation qui vous concerne
DSS-8608_KO: 당 기관은 최근에 초과 지급된 식품 및 영양 서비스에 대해 귀하에게 청구된 금액을 추심하여 적용했습니다.
DSS-8608_VI: Chúng tôi vừa thu nợ và áp dụng một số tiền yêu cầu bồi thường của quý vị cho Dịch Vụ Dinh Dưỡng và Thực Phẩm.
DSS-8608: TOP Reversal
DSS-8609_DE: Sozialversicherungsnummer – Steuernummer
DSS-8609_FR: Nous avons récemment recouvré
DSS-8609_KO: 당 기관은 최근에 초과 지급된 식품 및 영양 서비스에 대해 귀하에게 청구된
DSS-8609_VI: Gần đây chúng tôi đã
DSS-8609: Balance Due
DSS-8610_AR: الاسم الأول — الاسم الأخير
DSS-8610_DE: Sozialversicherungsnummer
DSS-8610_FR: Nous avons récemment recouvré ______________sur cette somme que vous deviez rembourser pour un excès d’émission de Services d’alimentation et de nutrition.
DSS-8610_KO: 당 기관은 최근에 초과 지급된 식품 및 영양 서비스에 대해 귀하에게 청구된
DSS-8610_VI: Gần đây chúng tôi đã
DSS-8610: Paid in Full Notice
DSS-8616: Food and Nutrition Services Workfare Referral Form
DSS-8616sp: Formulario De Inscripcion En Workfare” De Estampillas Para Alimentos”
DSS-8625: Food and Nutrition Services Program Facts
DSS-8627: A Serious Crime Public Assistance Fraud
DSS-8627sp: Fraude de asistencia pública (Public Assistance Fraud)
DSS-8628: Food and Nutrition Services Workfare Information Transmittal
DSS-8628sp: Transmision De Informacion De Workfare De Estampillas Para Alimentos
DSS-8632_AR: تأكيد التخفيض الطوعي للإعانات أو إنهاء الإعانات
DSS-8632_DE: Bestatigung Uber Freiwillige Reduzierung Oder Einstellung Von Leistungen
DSS-8632_KO: 혜택의 자발적 감액 또는 종료 확인
DSS-8632: Confirmation of Voluntary Reduction or Termination of Benefits
DSS-8632sp: Confirmacion De Reduccion O Terminacion Voluntaria De Beneficios
DSS-8633: Computer Inquiry Checklist
DSS-8636: Notice of Suspension
DSS-8639_AR: أثر التغيير الكلي على إعانات برنامج خدمات الطعام والتغذية
DSS-8639_DE: Auswirkung Von Massenanderung Auf Ihre Lebensmittelleistungen
DSS-8639_FR: Consequence Des Modifications Multiples Sur Vos Prestations Des Services D’Alimentation Et De Nutrition
DSS-8639_KO: 식품 및 영양 서비스 혜택에 대한 중대한 변경 사항의 영향
DSS-8639_VI: TÁC ĐỘNG CỦA THAY ĐỔI CHÍNH SÁCH TỚI PHÚC LỢI DỊCH VỤ DINH DƯỠNG VÀ THỰC PHẨM CỦA QUÝ VỊ
DSS-8639: Effect of Mass Change on Your Food and Nutrition Services Benefits
DSS-8639sp: Cambios En Sus Beneficios De Comida Y Nutricion
DSS-8640_AR: مسؤوليات متطلبات العمل
DSS-8640_DE: Arbeitsanforderungsverpflichtungen
DSS-8640_FR: Responsabilites Vis-À-Vis Des Obligations Professionnelles
DSS-8640_KO: 근로 요건 책임
DSS-8640_VI: YÊU CẦU TRÁCH NHIỆM TRONG CÔNG VIỆC
DSS-8640: Work Requirement Responsibilities
DSS-8640sp: Responsabilidades De Requisitos De Trabajo
DSS-8641: Work Readiness Checklist and Referral Form
DSS-8642_AR: شرح عدم الأهلية
DSS-8642_DE: Erklarung Der Disqualifikation
DSS-8642_FR: Explication D’Une Exclusion
DSS-8642_KO: 자격상실에 대한 설명
DSS-8642_VI: GIẢI THÍCH VIỆC TRUẤT QUYỀN
DSS-8642: Explanation of Disqualification
DSS-8642sp: Explicacion De Descalificacion
DSS-8643: Approval or Denial For Stolen Benefits
DSS-8643sp: Aprobación O Denegación Para Reemplazar Beneficios Electrónicos Robados
DSS-8644: Affidavit For Stolen Benefits
DSS-8644sp: Declaración jurada de beneficios robados
DSS-8650_AR: إخطار برنامج خدمات الطعام والتغذية بالمعلومات الضرورية
DSS-8650_DE: Lebensmittelleistungen Mitteiling Über Erforderliche Informationen
DSS-8650_FR: Notification D’Information Necessaire Pour Les Services D’Alimentation Et De Nutrition (FNS)
DSS-8650_HMN: FOOD AND NUTRITION SERVICES (FNS) DAIM NTAWV CEEB TOOM TXOG COV NTAUB NTAWV UAS YUAV TAU MUAB
DSS-8650_KO: 식품 및 영양 서비스(FNS)를 위한 필요 정보 요청 통지서
DSS-8650_VI: THÔNG BÁO CẦN THÔNG TIN CHO DỊCH VỤ DINH DƯỠNG VÀ THỰC PHẨM (FOOD AND NUTRITION SERVICES HAY FNS)
DSS-8650-Asp: Aviso de Información
DSS-8650: Notice of Information Needed to Complete your Food and Nutrition Services (FNS)
DSS-8650A_HMN: Npaj rau Food and Nutrition Services (FNS) Qhov Kev Xam Phaj
DSS-8650A: Notice of Information Needed English Version
DSS-8650sp: Programa De Servicios De Alimentos Y Nutricion (FNS) Aviso De Informacion Necesaria
DSS-8653: Notice to Debtor
DSS-8653sp: Aviso Al Deudor
DSS-8654_AR: نموذج إثبات دخل الطلاب
DSS-8654_DE: Nachweisformular Studenteneinkommen
DSS-8654_FR: Formulaire De Verification Des Revenus D’Etudiant
DSS-8654_KO: 학생 수입 확인서 양식
DSS-8654_VI: MẪU XÁC NHẬN THU NHẬP CỦA SINH VIÊN
DSS-8654: Student Income Verification Form
DSS-8655: Report of Medical Examination Requested by County DSS
DSS-8655sp: Informe De Examen Medico Solicitado Por El Departmento De Servicios Sociales (DSS) Del
DSS-8657: Benefit Diversion Agreement
DSS-8657sp: Acuerdo de desviación de beneficios
DSS-8658_AR: إخطار السداد اللاحق لجلسة الاستماع
DSS-8658_DE: Ruckforderungsbescheid Nach Anhorung
DSS-8658_FR: Notification De Remboursement Apres L’Audition
DSS-8658_KO: 심리 후 상환 고지
DSS-8658_VI: THÔNG BÁO TRẢ LẠI SAU ĐIỀU TRẦN
DSS-8658: Post Hearing Repayment Notice
DSS-8658sp: Aviso De Pago Despues De La Audiencia
DSS-9000 Policy Questions Form
DSS-9000 SA: Policy Question Form
DSS-9001: Food and Nutrition Services (FNS) Qualified Professional in Substance Abuse Request for Good Cause
DSS-9001sp: Servicios de Alimentos y Nutrición (FNS) Profesional Calificado en Solicitud de Abuso de Sustancias por Buena Causa
NCFAST – 20009 Form in Gujarati
NCFAST – 20009 Form in Hindi
NCFAST – 20009 Form in Japanese
NCFAST – 20009 Form in Khmer
NCFAST – 20009 Form in Lao
NCFAST – 20009 Form in Russian
NCFAST – 20009 Form in Ukraine
NCFAST – 20009 North Carolina Cov Kev Muaj Cai thiab Cov Luag Hauj Lwm rau Kev Pab Zej Tsoom
NCFAST – 20009 North Carolina 公共援助的权利和责任
NCFAST 20009_AR: الحقوق والمسؤوليات في برنامج المساعدات العامة في ولاية كارولاينا الشمالية القسم 1 : حقوق المتقدم ومسؤولياته
NCFAST-20009 North Carolina Rights and Responsibilities for Public Assistance
NCFAST-20009_DE: Öffentliche Unterstützung in North Carolina – Rechte und Verantwortungen
NCFAST-20009_FR: Droits et responsabilités de l’aide publique de Caroline du Nord
NCFAST-20009_KO: 노스캐롤라이나 주 공적 부조 권리 및 의무 섹션 1: 신청자 권리와 의무
NCFAST-20009sp: Asistencia Pública de Carolina del Norte – Derechos y Responsabilidades
NCFST-20009_VI: Các Quyền và Trách Nhiệm về Trợ Cấp Công Cộng Tại Bắc Carolina