The Department of Social Services provides a variety of forms for different purposes. The DSS Form 1613 5 is used to request financial assistance to help pay for housing costs. This form can be used by individuals or families who are homeless or at risk of becoming homeless. In order to complete the form, you will need to provide information about your current housing situation and your income and expenses.
| Question | Answer |
|---|---|
| Form Name | Dss Form 1613 5 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | 1613 5 dss form 1613 5 |
South Carolina Department of Social Services
MONITOR RESPONSIBILITY
Page of
Instructions: List in column 1 the center(s) your institution sponsors or plans to sponsor. In column 2 indicate the staff person who will monitor this center for CACFP purposes and the staff person’s physical address. In column 3, indicate how long the staff person has been a monitor with your institution. Attach more sheets if necessary.
Center(s) Monitored
Name of Monitor and Physical Address of Monitor’s Office
Length of Time
Employed as a
Monitor
DSS Form
Center(s) Monitored
Name of Monitor and Physical Address of Monitor’s Office
Length of Time
Employed as a
Monitor
DSS Form |
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