The DSS 30249 form represents a crucial document administered by the South Carolina Department of Social Services, designed to facilitate financial transactions related to foster care. Specifically, this form addresses payments for either foster care respite or college youth overnight stays, presenting a structured means for compensating providers for their services. Key features of this form include sections to identify the provider, including name, mailing address, and Social Security Number, alongside verification if a Form W-9 has been completed to ensure compliance with IRS reporting requirements. Providers might find themselves receiving a Form 1099 for tax purposes based on the payment information disclosed. Furthermore, the form requires detailed identification of the foster child or college youth in question, along with the foster parent or individual requesting the respite service. The inclusion of dates pertaining to the respite or overnight visits, along with requisite signatures from both the provider and caseworker, underscores the form’s intention to ensure a transparent and verifiable process. Closing steps include an evaluation by the DSS State Office, where the amount due is calculated and finalized, emphasizing the bureaucratic process that oversees these transactions. The DSS Form 30249, with its comprehensive structure, thus enables a direct and organized method for managing specific financial aspects within the foster care system.
| Question | Answer |
|---|---|
| Form Name | Dss Form 30249 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | 3807a form, dss form 3807a, dss form 3807a april 18, sc dss recertification form |
South Carolina Department of Social Services
FOSTER CARE RESPITE/COLLEGE YOUTH OVERNIGHT PAYMENT INVOICE
Foster Care Respite Payment
OR
College Youth Overnight Payment
Make check Payable to:
Name of Provider:
Mailing Address:
Provider Social Security Number:
Form
Name of Foster Child:
Foster Parent Requesting Respite OR Name of College Youth Attends:
Date(s) of Respite/Overnight Visits:
Provider Signature: |
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Date: |
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Caseworker Signature: |
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Date: |
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FOR DSS STATE OFFICE ONLY |
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Amount Due:
Foster Parent Requesting Respite:
Provider ID No.:
Signature, Human Services Staff, State Office |
Date |
DSS Form 30249 (APR 10) Edition of FEB 10 is obsolete.