What forms are required for a TANF certification with parent included in benefit?
Note: Drug Screen Requirement Acknowledgment Form must be signed by the client and uploaded to Onbase
- Request for Benefits, 08MP001E (PS-1), Paper applicants only.
- Responsibility and Signature for Benefits, 08MP003E (FSS-1-B), Paper applicants only.
Note: With two-parent households each parent must sign the FSS-1-B.
- Effect of Lump Sum Payments on TANF benefits, 08TA006E (FSS-C-4), Paper applicants only.
- Citizenship affidavit, 08MP005E (when birth certificate is not provided).
- Declaration of citizen status, 08MP022E (for non US citizens).
- Out of State TANF benefits, 08AD080E (ADM-80)
Note: if client declares they have lived in any other state since birth of oldest child.
- School Attendance Verification for school age children, 08AD010E.
- Immunization Certificate of Exemption, 08TA017E (FSS-TANF-1), if needed.
- Deprivation
- Deprivation based on absence
- Non-Custodial Parent Letter, 08AD008E (ADM-95) if the address of noncustodial parent is available.
- Good Cause Report, 08TA009E (C-15) when good cause is requested.
- Child Support Services and Responsibilities, (C-16) given to client Paper applicants only.
- Cooperation Agreement and Request for Good Cause, 08TA012E (C-9) Paper applicants only.
Note: 08TA009E (C-15) is the form that will be emailed to AFS.TANF@OKDHS.ORG by a supervisor. All other child support forms are to be imaged into the case record.
- Deprivation based on Unemployed parent, if needed.
- Deprivation based on incapacity, if needed.
- Deprivation based on absence
- TANF Work/Personal Responsibility Agreement, 08TW002E (TW-2) pages 1&2
- Interagency Referral and Information, 08TW003E (TW-3)
What forms are required for a TANF certification (Child only)?
- Request for Benefits (PS-1), paper applicants only.
- Responsibilities and Signature for Benefits (FSS-1-B), Paper applicants only.
- Effect of Lump Sum Payments on TANF benefits (FSS-C-4), Paper applicants only.
- Child Support Forms (for both parents when applicable):
- Non-Custodial Parent Letter, 08AD008E (ADM-95) if the address of noncustodial parent is available.
- Good Cause Report, 08TA009E (C-15) when good cause is requested.
- Child Support Services and Responsibilities, 03AX016E (C-16) given to client, Paper applicants only.
- Cooperation Agreement and Request for Good Cause, 08TA012E (C-9), Paper applicants only.
Note: 08TA009E (C-15) is the only form that will be emailed to afs.TANF@okdhs.org by a supervisor. All other child support forms are to be imaged into the case record.
- School Attendance Verification for school age children, 08AD010E.
- Immunization Certificate of Exemption, 08TA017E (FSS-TANF-1), if needed.
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