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Forms

All the forms on this page require Adobe Acrobat.

The following forms can be completed online and then printed.

IV-D Application for Assisted Guardianship 51802/CSB 0007

Arrearage Calculation Worksheet 51799/CSB 0008

Child Registration: Indiana Special Needs Adoption Program (SNAP) Picture Book 11840/CW 1440

Consent to Release Criminal History Information for Approved Relative, Foster Family, or Adoptive Home License 49996/CW 0040
Allows the Department of Child Services to perform a criminal history check on applicants for prospective foster parents, kinship/relative parents, or adoptive parents.

Direct Deposit Authorization 51519/CSB 0006

Employer Online Payment System Website Setup Information 51796/CSB 0010

Financial Statement 51798/CSB 0011

Purchase Order - Foster Care 27116
Allows foster parent in Vanderburgh county to purchase clothing for children who have entered substitute care.

These forms cannot be filled in online. They may be printed out and filled in by hand or typewriter.

Adoption Assistance: Child Certification 02976/CW 0020

Applicant's Statement of Attestation 46151/CW 0025
A notarized statement that the child care center/home applicant has not been charged with or convicted of a felony or a misdemeanor related to the health or safety of children.

Application for Adoption 49794/CW 0026
Application for consideration as an adoptive family for those who are interested in adopting a child.

Application for Adoption Assistance 02973/CW 3310
Application for the Title IV-E Adoption Assistance Program for the eligible special needs adoptive child.

Application for Child Abuse Research 00116/CW 0321
Used to insure that children in the care of the state are not subjected to unreasonable intrusion or involvement if it is deemed appropriate for them to be part of a child abuse research project in any way - either directly or through use of their personal information. This form is used by individuals interested in conducting child abuse or neglect research that would involve gathering information about or directly from children in the care of the state.

Application for Foster Family Home License or Approved Relative Home 10100/CW 0317
Documents pertinent information about those seeking to provide foster care to children in the care of the state.

Aviso De Disponibilidad De Los Informes E Informacion Completados: Investigacion De Presunto Abuso O Negligencia Infantil 51866/CW 0024S

County Adoption Subsidy Agreement 51887/CW 0048

Direct Vendor Payment Authorization and Certification 47701/CW 3616
Signed authorization form required of the adoptive parent(s) who wish to authorize the Division of Family and Children to make direct payment(s) of Title IV-E Non-Recurring Adoption Expenses (NRAE) to the lawyer handling the adoption of the eligible child for them.

Employer Remittance 51923/CSB 0013

Initial Inquiry Regarding Foster Family Home Licensure 53204/CW 3618

Notice of Availability of Completed Reports and Information: Investigation of Allegations of Child Abuse or Neglect 48201/CW 0024

Preliminary Report of Alleged Child Abuse or Neglect 00114/CW 0310
Used to document allegations of abuse or neglect. Agencies who report abuse or neglect follow up the report using this form to document and send the written report to the local child protection office.

Recommendation for Foster Family Home Care License or Relative Home Care License 17769/CW 0335

Request by a Person or Organization for a Search of the State Central Registry 49214/CW 0005 (Pending)
Allows Licensed Child Placing Agencies to request DCS to complete a CPS history on a specified person who wants to be a foster or adoptive parent.