TANF: Forms for TANF Certification

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

  1. Request for Benefits,  08MP001E (PS-1), Paper applicants only.
  2. 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.
  1. Effect of Lump Sum Payments on TANF benefits,  08TA006E (FSS-C-4), Paper applicants only.
  2. Citizenship affidavit, 08MP005E (when birth certificate is not provided).
  3. Declaration of citizen status, 08MP022E (for non US citizens).
  4. Out of State TANF benefits, 08AD080E (ADM-80)
    Note: if client declares they have lived in any other state since birth of oldest child.
  5. School Attendance Verification for school age children, 08AD010E.
  6. Immunization Certificate of Exemption, 08TA017E (FSS-TANF-1), if needed.
  7. Deprivation
  1. TANF Work/Personal Responsibility Agreement, 08TW002E (TW-2) pages 1&2
  2. Interagency Referral and Information, 08TW003E (TW-3)

What forms are required for a TANF certification (Child only)?

  1. Request for Benefits (PS-1), paper applicants only.
  2. Responsibilities and Signature for Benefits (FSS-1-B), Paper applicants only.
  3. Effect of Lump Sum Payments on TANF benefits (FSS-C-4), Paper applicants only.
  4. Child Support Forms (for both parents when applicable):
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.

 

  1. School Attendance Verification for school age children, 08AD010E.
  2. Immunization Certificate of Exemption, 08TA017E (FSS-TANF-1), if needed.
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