Get Ldss 4623c 2

The Ldss 4623c 2 form is essential for amending the Adoption Subsidy and Non-Recurring Adoption Expenses Agreement in New York State. This guide will provide step-by-step instructions on how to complete the form online, ensuring that you can efficiently submit your amendment.

Follow the steps to successfully complete the Ldss 4623c 2 online.

1. Press the ‘Get Form’ button to access the document. This will allow you to open the form in the editor for online completion.
2. Begin with the section titled 'Adoptive Parent/Legal Guardian or Custodian/Representative Payee', where you must enter the names of all adoptive parents or legal guardians involved in the amendment.
3. Provide details regarding the adoption, including the name of the child and the date the adoption was finalized. Ensure all dates are entered in the correct format (month/day/year).
4. In Section I, indicate if there is a deceased parent and detail the appointment of a legal guardian or custodian if applicable. Enter the names and addresses of legal guardians or custodians.
5. For Section II, briefly describe the purpose of your amendment. You may summarize the changes being requested in the agreement.
6. Complete Section III by selecting the appropriate category that reflects the subsidy condition of the child, ensuring to check all relevant boxes.
7. In Section IV, indicate whether the child is eligible for federal adoption assistance, specifying their status accordingly.
8. Proceed to Section V to select the medical assistance/medical subsidy relevant to the child. Choose the options that apply based on the child's conditions.
9. Fill out Section VI regarding maintenance subsidy calculations. Include the current board rate and any requested changes to the subsidy rate.
10. For Section VII, note any adjustments to maintenance payments that apply as per the current county guidelines.
11. Complete Section VIII if you are applying for Non-Recurring Adoption Expenses, indicating whether you wish to apply or not.
12. In Section IX, both adoptive parents or guardians must sign and date the form, confirming their understanding and agreement to the terms.
13. Sections X, XI, and XII require official signatures from the appropriate social services district and voluntary authorized agency. Ensure these sections are completed as necessary.
14. Once all sections are completed and reviewed for accuracy, save the changes and choose to download, print, or share the completed form as needed.

Complete your Ldss 4623c 2 form online today to ensure a smooth amendment process.