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 Oct 01, 2022 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