Applications and forms
SCDJFS 5136 FA Work Registration Screening Assessment
SCDJFS 6049 Child Care Change Report
SCDJFS 6126 Applicant Questionnaire
SCDJFS 7002 Employment Wage Verification
SCDJFS 7029 Change Report with Voter Registration
ODM 06723 Designation of Authorized Representative
JFS 01124 Re-Determination Application for Child Care Benefits (open case – ongoing)
JFS 01138 Application for Child Care Benefits (new applicant)
ODM 02399 Request for Medicaid Home & Community-Based Services
ODM 03528 Healthchek and Pregnancy Related Services Information Sheet
JFS 07200 Request for Cash, Food and Medical Assistance
• Food and Nutrition Service (FNS) Nondiscrimination Statement
JFS 07204 Request to Reapply for Cash and Food Assistance
ODM 07216 Application for Health Coverage & Help Paying Costs
JFS 07501 Program Enrollment and Benefit Information