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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:

10.5fc

CP&P Form 10-5fc, Title IV-E Foster Care Eligibility Initial Determination

 

 

 

Click here to view or print CP&P Form 10-5fc, Title IV- E Foster Care Eligibility Initial Determination.

 

WHEN TO USE IT

 

This form is used by the Title IV-E Reviewer to determine Title IV-E Foster Care Initial Determination for all children entering a CP&P-approved, out-of-home placement.

 

This form is used to certify Title IV-E Foster Care eligibility in accordance with Federal government requirements.

 

HOW TO USE IT

 

•           Access it through the NJ SPIRIT Desktop> Eligibility Window-Determinations Tab> Options 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

 

•           CP&P Form 10-5fc prefills from entries made in the NJ SPIRIT application.

 

•           Print the completed form.  Attach all supporting documentation to CP&P Form 10-5fc.  Distribute/file in accordance with "Distribution," below.

 

            Supporting documents include, but are not limited to: written statements regarding removal from the home, signed Court Order, and proof of family income and financial assets.

 

DISTRIBUTION

 

Original          -        Title IV-E Eligibility and Determination Unit file

 

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

 

Copy              -         Local Office IV-E file

 

Electronic Copy      NJ SPIRIT Electronic Case Record