NC Department of Health & Human Services
Search for:
Home
Departmental
Departmental Forms
Departmental Policies/Manuals
Section I – Policy Coordination
Section II – Budget and Finance
Administrative Manual for Collection of Salary Overpayments
Cash Management
DSS Fiscal Manual
Fiscal Non-Profit Administration
Section IV – General Administration
Section V – Human Resources
Section VI – Property and Construction
Section VII – Procurement and Contract Services
Section VIII – Privacy and Security
Section IX – Transportation Services
Section X – Information Technology
Section XI – Employee Wellness
Departmental Secretarial Directives
Divisional A-M
Aging Services
Child Development and Early Education
Subsidized Child Care Assistance
SCCA Policy Manual
SCCA Forms
SCCA Administrative Letters
SCCA Dear County Director Letters
SCCA Change Notices
Health Benefits/NC Medicaid
Adult Medicaid
ABD Policies/Manuals
ABD Administrative Letters
ABD Change Notices
Basic Medicaid Eligibility Requirements
Eligibility Information System (EIS)
Family and Children’s Medicaid
FCM Policies/Manuals
FCM Administrative Letters
FCM Change Notices
DHB Forms
Health Service Regulation
Mental Health, Developmental Disabilities and Substance Use Services
Divisional N-Z
Public Health
Services for the Blind
SB Policies/Manuals
Administrative Policies and Procedures
Independent Living Services Program Manual
Independent Living Older Blind Policies and Procedures Manual
Medical Eye Care Services Program Manual
Register of the Blind Procedure Manual
Vocational Rehabilitation
SB Forms
Services for the Deaf and Hard of Hearing
Social Services
Adult Services
Adult Protective Services
Guardianship
General Adult Services
Child Support
Child Welfare Services
CWS Policies/Manuals
CWS Administrative Letters
CWS Change Notices
Energy Programs
EP Policies/Manuals
EP Administrative Letters
EP Change Notices
Enterprise Program Integrity Control System (EPICS)
EPICS Policies/Manuals
EPICS Administrative Letters
EPICS Change Notices
Food and Nutrition
Services
FNS Policies/Manuals
FNS Administrative Letters
FNS Change Notices
Food and Nutrition Services Disaster
FNSD Policies/Manuals
FNSD Administrative Letters
FNSD Change Notices
Food Stamp Information System (FSIS) Users
FSIS Policies/Manuals
FSIS Administrative Letters
FSIS Change Notices
Performance Management/Reporting and Evaluation
PMRE Policies/Manuals
PMRE Administrative Letters
PMRE Change Notices
Refugee Assistance
RA Policies/Manuals
RA Administrative Letters
RA Change Notices
Services Information System (SIS)
SIS Policies/Manuals
SIS Administrative Letters
SIS Change Notices
Special Assistance
Special Assistance
Special Assistance in Home Program
Special Assistance in Home Case Management
SS Forms
Forms in English
Forms in Other Languages
Work First
WF Policies/Manuals
WF Administrative Letters
WF Change Notices
Work First Users
WFU Policies/Manuals
WFU Administrative Letters
WFU Change Notices
X/PTR – Report Distribution System
Vocational Rehabilitation Services
Full Document Library
Full Document Library
Document Search
DSS-1678: Replacement/Supplement Affidavit
Open
Preview
File Type:
pdf
File Size:
122 KB
Categories:
Social Services
Tags:
Form