background shadows

NJ DCF Logo with reverse copy

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

9-8-2009

Subchapter:

1

Forms

Issuance:

10.5aa

CP&P Form 10-5aa, Title IV-V Adoption Assistance Eligibility Determination

 

Click here to view or print CP&P Form 10-5aa, Title IV Adoption Assistance Eligibility Determination.

 

WHEN TO USE IT

 

This form is used by the Title IV-E Reviewer to determine Title IV-E Adoption Assistance Eligibility for children whose adoptions are finalized, and remain active CP&P cases in the subsidized adoption program.

 

Complete within 60 days of finalization of the child's adoption.

 

Complete within 60 days of the adopted youth turning 18 if he or she has previously been determined eligible, will remain in a subsidized adoption, and continues to meet Federal requirements.

 

This form is used to record certification of eligibility for Title IV-E/AA in accordance with Federal government requirements.

 

HOW TO USE IT

 

·         Access it through the NJ SPIRIT Desktop> Adoption Eligibility Window> Dropdown

·         Only complete this template outside of the NJ SPIRIT application as part of a contingency plan when the application is unavailable.  However, in doing so, you are still required to create the form in NJ SPIRIT when the application becomes available.

TIPS FOR COMPLETING THE FORM

 

·         The Child Identification Information (in the boxed area at the top of the form) automatically prefills, based on information in the Person Management Window in NJ SPIRIT.

·         The Determination of Eligibility is automatically pre-selected in NJS, based on the selections made.

·         When completing the form manually, check the Eligibility Determination "YES" or "NO," as applicable, to indicate whether the child meets the criteria required by Federal Law for Title IV-E/AA eligibility. 

DISTRIBUTION

 

Original          -        Title IV-E Eligibility and Determination Unit file

 

Copy              -         Child's subsidy case record (file in "financial" section)

 

Copy              -         Local Office IV-E file

 

Electronic Copy      NJ SPIRIT Electronic Case Record