Forms
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.
https://policies.ncdhhs.gov/divisional/social-services/forms
https://policies.ncdhhs.gov/logo.png
Forms
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.
| Title |
Effective Date |
|
DSS-1821ins: NC Kids Family Registration Form Instructions
|
Nov 27, 2019 03:27 PM
|
|
DSS-1837: Interstate Compact on the Placement of Children Request (ICPC 100A)
|
Jun 03, 2016 04:10 PM
|
|
DSS-1837I: Instructions for Completing Form ICPC-100A Interstate Compact on the Placement of Children Request
|
Jun 03, 2016 04:10 PM
|
|
DSS-1838: Interstate Compact Report on Child's Placement Status (ICPC 100B)
|
Jun 03, 2016 04:15 PM
|
|
DSS-1838I: Instructions for Completing Form ICPC-100B Interstate Compact Report on Child's Placement Status
|
Jun 03, 2016 04:10 PM
|
|
DSS-1839: Regulation 7 Form Order for Expedited Placement Decision Pursuant to the ICPC
|
Jun 03, 2016 04:15 PM
|
|
DSS-1840: Regulation # 7 Case Manager Statement of Interest
|
Jun 03, 2016 04:15 PM
|
|
DSS-1841: Regulation # 2 Case Manager Statement of Interest
|
Jun 03, 2016 04:15 PM
|
|
DSS-2141: Monthly Requisition For Forms
|
Jun 03, 2016 04:20 PM
|
|
DSS-2203: Daysheet
|
Jun 03, 2016 04:20 PM
|
|
DSS-2204: Day Summary Sheet
|
Jun 03, 2016 04:20 PM
|
|
DSS-2216: Request for Record
|
Jun 03, 2016 04:20 PM
|
|
DSS-2239: IV-D Legal Services Bill
|
Jun 03, 2016 04:25 PM
|
|
DSS-2249: Affidavit Of Adoption Expenditures
|
Jun 03, 2016 04:25 PM
|
|
DSS-2250: Adoption Assistance Payment Authorization Notice
|
Jun 03, 2016 07:55 AM
|
|
DSS-2435i: Food and Nutrition Services (FNS) Notice of Expiration and Interview Recertification Form
|
Sep 01, 2023 08:10 PM
|
|
DSS-2435r: Food and Nutrition Services (FNS) Notice of Expiration Recertification Form
|
Oct 01, 2022 07:00 PM
|
|
DSS-2435sri: Rights and Responsibilities
|
Mar 23, 2017 08:00 AM
|
|
DSS-2624: Food and Nutrition Services Referral Form
|
Jun 03, 2016 08:00 AM
|
|
DSS-2625: Food and Nutrition Services E&T Information Transmittal
|
Jun 03, 2016 08:00 AM
|
|
DSS-2807-II: Part II, Report on Local Hearings
|
Jun 03, 2016 08:25 AM
|
|
DSS-2807: Part 1, Report on Local Hearings - Summary
|
Jun 03, 2016 08:20 AM
|
|
DSS-3431: Request for Financial Information
|
Jun 03, 2016 08:30 AM
|
|
DSS-4278: Reunification Referring Agency Referral Form
|
Jun 03, 2016 08:30 AM
|
|
DSS-4279: Intensive Family Preservation Referring Agency Referral Form
|
Jun 03, 2016 08:35 AM
|
|
DSS-4451: Application for Child Support Services
|
Apr 01, 2022 08:35 AM
|
|
DSS-4718: CSE Direct Deposit Authorization
|
Jun 03, 2016 08:35 AM
|
|
DSS-5002: Child Welfare Services Corrective Action Plan
|
Jul 09, 2018 08:40 AM
|
|
DSS-5009: Fatality Notification
|
Dec 30, 2020 05:00 PM
|
|
DSS-5009A: Instructions for Fatality Notification
|
Dec 30, 2020 05:05 PM
|
