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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: 2-11-2013

Volume:

X

Forms

Chapter:

A

Forms

Revised Date: 10-04-2021

Subchapter:

1

Forms

Issuance:

4.25

CP&P Form 4-25, Eligibility Criteria for CP&P KLG Subsidy

 

Click here to view, complete, and print the CP&P Form 4-25, Eligibility Criteria for CP&P KLG Subsidy.

 

WHEN TO USE IT

 

The Worker uses the CP&P Form 4-25 in conjunction with CP&P Form 4-24, Request for KLG Subsidy Approval Memo, when making a KLG subsidy request. All attachments listed on the CP&P 4-25 must be checked off and included in the KLG subsidy request packet. Listed CP&P Forms must be approved by appropriate staff and copies must have all required signatures. Attachments include copies of the:

         Permanency Court Order;

         Resource Family License indicating family has been licensed for a minimum of six months;

         Signed and dated Acknowledgement of Receipt of Adoption/KLG  Comparison Chart, last page of CP&P Form 4-18;

          Area Director approval and signature is required for a legally free child or a child placed with a non-kin caregiver and;

         Rate Assessment.

 

HOW TO USE IT

 

Prepare the form using the on-line template in the computerized Forms Manual (1-10) after you have completed or collected all required attachments for a KLG subsidy request.

Sign the form and forward it with the attachments to your assigned Supervisor for approval and sign off. The assigned Casework Supervisor approves and signs the CP&P Form 4-25.

Send this form with the completed CP&P Form 4-24 in the subsidy request packet (including all forms and documentation) to the Office of Adoption Operations, Cost Code # 966, or fax the packet to 609-984-5449. (Note: Inter-office mail is preferred.)

Note: Failure to attach appropriate documentation will delay processing of the KLG subsidy request.

 

TIPS FOR COMPLETING THE FORM

 

         All text fields must be completed.

         Select all check boxes for required attachments.

         Attach all forms and documentation.

 

DISTRIBUTION

 

Original          -     

Office of Adoption Operations

Copy             - 

Child's case record with entire request packet (Update once the approval is received).