fsep guide n.
Skip this Video
Loading SlideShow in 5 Seconds..
FSEP Guide PowerPoint Presentation
Download Presentation
FSEP Guide

Loading in 2 Seconds...

play fullscreen
1 / 28

FSEP Guide - PowerPoint PPT Presentation

  • Uploaded on

FSEP Guide. DCBS forms for a Family Support Caseworker. Click Here to Begin. What forms do I use in my case setup? Let’s start with the 116. Let’s start with the 202. Special Case Forms. 203 Checklist and forms for client. DCBS Intranet Forms Finish. PAFS 116 includes: PAFS 203

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

FSEP Guide

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
fsep guide

FSEP Guide

DCBS forms for a Family Support Caseworker

Click Here to Begin


What forms do I use in my case setup?

Let’s start with the 116.

Let’s start with the 202.

Special Case Forms.

203 Checklist and forms for client.

DCBS Intranet Forms


PAFS 116 includes:

PAFS 203

PAFS 706

Birth Records

Identity Verification

Custody, Child Support and Divorce Records


Back to Start

PAFS 202 includes:

KIM 101 (Application)

FS 8


PAFS 121

FS 704


PAFS 700

PAFS 702

Back to Start


Child Care Verification Form

Back to 202 Click Here


Statement of Disability or Incapacity. Not used for incapacity Medicaid cases.

Back to 202 Click Here


Student Income Verification Form

Completed by Financial Aid Office

Back to 202 Click Here


Irregular Work Form

Used with Odd Job and Seasonal Employment

Back to 202 Click Here


Verification of No Income. To be completed by non-member that knows applicants income situation well.

Back to 202 Click Here


Used for Voter Reg. Rights & Declination

Will NOT change the applicants eligibility

Back to 116 Click Here


Used for Simplified Reporting Requirements, Rights & Responsibilities with all Food Benefit Applications.

Back to 202 Click Here


Change Report Form

Used to record reported changes from recipients

Back to other Case Forms


Intent to Apply

Used for applicants with intent to apply for benefits

Back to other Case Forms


Clients receive these forms from the PAFS 203 Checklist : PAFS 120FS 360 FS 500.1 FSET 101 PAFS 600Civil Rights Pamphlet Back to Start


Civil Rights Pamphlet

Advises all applicants of their civil rights, including their right for a hearing.

Back to Checklist


Employment and Training Fact Sheet

Information on the Employment Training Program

Back to Checklist


Consent and Release of Client Information and Records.

Used when additional information needs to be obtained from a third party.

Back to 116 Click Here



  • (1/09) Cabinet for Health and Family Services
  • Department for Community Based Services
  • Do you have a physical or mental condition that makes it hard for you to:
  • Apply for K-TAP, Medicaid, Food Benefits or other benefits?
  • Keep appointments with us?
  • Do a task or activity we ask you to?
  • If you do, we can help you. We can also help you if you care for a family member and that care makes it hard for you to get benefits. This flyer tells you why and how we can help.
  • Americans with Disabilities Act (ADA)
  • The law: You have the right under the Americans with Disabilities Act (ADA) to get
  • help applying for and keeping benefits. You can get help with any activity needed to
  • use our programs.
  • Who it protects: You have rights under the ADA if any kind of health problem makes it hard for you to do something basic and important, like:
    • care for yourself
    • walk, stand, or sit
    • see, hear, or talk
    • breathe
    • learn
    • remember things
    • do tasks with your hands
    • work
  • The problem can be physical, like diabetes, asthma, or migraine headaches. Or it can be mental or emotional, like depression, anxiety, ADD or ADHD. It can also be a learning disability.
  • You do not have to get disability benefits to get this help.

PAFS 600

Fact sheet for Americans with Disabilities Act (ADA)

Back to Checklist


Facts About Food Stamp Benefits

Information Fact Sheet

Back to Checklist


Family Support Forms:

Access General Forms Workbook, or scroll page to access Table of Contents for Family Support forms.

Comprehensive Table of Contents:

Section I Food Stamp Forms

Section II Public Assistance/Food Stamp Forms

Section III Public Assistance Forms

Section IIIA KWP Forms

Section IV DCBS Forms

Section V Claims/Fraud Forms

Section VI Miscellaneous Forms

Section VII Publications

Section VIII KAMES Forms

Section IX Report Series Forms

Back to Start


Don’t forget: Some local offices use additional forms for case setup. Check with your supervisor regarding your office procedures.You are now ready to continue with assignments under Part I on Blackboard.

Back to Start