Get Dss-1840. Regulation # 7 Case Manager Statement Of Interest

This guide provides a step-by-step approach to filling out the DSS-1840. Regulation # 7 Case Manager Statement Of Interest form online. The instructions are designed to support users with varying levels of experience in document management.

Follow the steps to successfully complete the form.

1. Press the 'Get Form' button to access the DSS-1840 form and open it in the document editor.
2. Begin by entering the identifying information for the placement resource. Fill in the full name with spaces for last name, first name, and middle initial. Next, provide the complete address, including street address, apartment/unit number, city, county, state, and ZIP code.
3. Enter the home phone number, alternate phone number, and email address. Indicate whether the placement resource is interested in placement and agrees to participate in the process.
4. Fill out the social security number or government ID, and provide the name and phone number of the employer. Specify the relationship to the child being placed.
5. If applicable, include the spouse's name, along with their alternate phone number and employer's information.
6. Detail the number of rooms available in the home, including the number of bedrooms, other rooms, and the square footage. Note how many adults and children currently reside in the home.
7. List the names, dates of birth, and social security numbers of other adults living in the home, along with their contact information if it differs from the previously entered information.
8. In the section for signed statements, check the boxes to confirm the placement resource’s interest and willingness to cooperate with the ICPC process. Acknowledge discussions about criminal records and child abuse history checks as required by law.
9. Confirm that the placement resource will access financial resources for the child’s care and outline any childcare needs along with a corresponding plan.
10. If relevant, indicate if a request is being made for concurrence to relinquish jurisdiction, and specify details regarding the placement sought.
11. Provide the date of discussion, followed by the case manager's first and last name, county of operation, and date of signing. Include the supervisor's name and any additional information that may be necessary.
12. Once you have completed all sections of the form, review your entries for accuracy and clarity. Users can then save changes, download, print, or share the completed form.

Begin completing your DSS-1840 online now to ensure a smooth submission process.