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282
![DSS Form 1 "Chip Notice F006 Appointment Letter Initial Application" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19175/1917571/dss-form-1-chip-notice-f006-appointment-letter-initial-application-south-carolina.png "DSS Form 1 "Chip Notice F006 Appointment Letter Initial Application" - South Carolina")
![DSS Formulario 1 "Aviso Chip F006 - Solicitud Inicial-aviso De Cita" - South Carolina (Spanish)](https://data.templateroller.com/pdf_docs_html/1917/19175/1917573/dss-form-f-006-solicitud-inicial-aviso-de-cita-south-carolina.png "DSS Formulario 1 "Aviso Chip F006 - Solicitud Inicial-aviso De Cita" - South Carolina (Spanish)")
![DSS Form 1 "Chip Notice C021 - Food Stamps - Phone Recertification Appointment Notice" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19175/1917570/dss-form-1-chip-notice-c021-food-stamps-phone-recertification-appointment-notice-south-carolina.png "DSS Form 1 "Chip Notice C021 - Food Stamps - Phone Recertification Appointment Notice" - South Carolina")
![DSS Formulario 1 "Aviso Chip C021 - Aviso De Cita Para Recertificacion Telefonica" - South Carolina (Spanish)](https://data.templateroller.com/pdf_docs_html/1917/19175/1917569/dss-form-c-021-aviso-de-cita-para-recertificacion-telefonica-south-carolina.png "DSS Formulario 1 "Aviso Chip C021 - Aviso De Cita Para Recertificacion Telefonica" - South Carolina (Spanish)")
![DSS Formulario 1245 "Solicitud De Informacion Salarial" - South Carolina (Spanish)](https://data.templateroller.com/pdf_docs_html/2213/22131/2213154/dss-formulario-1245-solicitud-de-informacion-salarial-south-carolina-spanish.png "DSS Formulario 1245 "Solicitud De Informacion Salarial" - South Carolina (Spanish)")
DSS Formulario 1245 "Solicitud De Informacion Salarial" - South Carolina (Spanish)
Size: 257 KB
2 pages
![DSS Form 1670 "Dependent Care Payment Verification Form" - South Carolina](https://data.templateroller.com/pdf_docs_html/2213/22131/2213151/dss-form-1670-dependent-care-payment-verification-form-south-carolina.png "DSS Form 1670 "Dependent Care Payment Verification Form" - South Carolina")
![DSS Form 1245 "Request for Wage Information" - South Carolina](https://data.templateroller.com/pdf_docs_html/2213/22131/2213153/dss-form-1245-request-for-wage-information-south-carolina.png "DSS Form 1245 "Request for Wage Information" - South Carolina")
![DSS Form 3249 "Newborn Verification of Application for Social Security Number" - South Carolina](https://data.templateroller.com/pdf_docs_html/2169/21695/2169570/dss-form-3249-newborn-verification-of-application-for-social-security-number-south-carolina.png "DSS Form 3249 "Newborn Verification of Application for Social Security Number" - South Carolina")
![DSS Form 2454 "Room/Boarder Payment Verification Form" - South Carolina](https://data.templateroller.com/pdf_docs_html/2169/21695/2169568/dss-form-2454-room-boarder-payment-verification-form-south-carolina.png "DSS Form 2454 "Room/Boarder Payment Verification Form" - South Carolina")
![DSS Form 2012 "Landlord/Owner Statement" - South Carolina](https://data.templateroller.com/pdf_docs_html/2138/21383/2138368/dss-form-2012-landlord-owner-statement-south-carolina.png "DSS Form 2012 "Landlord/Owner Statement" - South Carolina")
![DSS Form 2667 "Spanish-English Interpreting Invoice" - South Carolina](https://data.templateroller.com/pdf_docs_html/2089/20893/2089322/dss-form-2667-spanish-english-interpreting-invoice-south-carolina.png "DSS Form 2667 "Spanish-English Interpreting Invoice" - South Carolina")
![DSS Form 1766 "Declaration Statement" - South Carolina](https://data.templateroller.com/pdf_docs_html/2089/20893/2089321/dss-form-1766-declaration-statement-south-carolina.png "DSS Form 1766 "Declaration Statement" - South Carolina")
![DSS Form 1247 "Medical Release/Physician's Statement" - South Carolina](https://data.templateroller.com/pdf_docs_html/2068/20689/2068910/dss-form-1247-medical-release-physician-s-statement-south-carolina.png "DSS Form 1247 "Medical Release/Physician's Statement" - South Carolina")
![DSS Form 3800 "Temporary Assistance for Needy Families (TANF) Application/Supplemental Nutrition Assistance Program (Snap) Application/Refugee Cash Assistance (Rca) Application" - South Carolina](https://data.templateroller.com/pdf_docs_html/2174/21741/2174153/dss-form-3800-temporary-assistance-for-needy-families-tanf-application-supplemental-nutrition-assistance-program-snap-application-refugee-cash-assistance-rca-application-south-carolina.png "DSS Form 3800 "Temporary Assistance for Needy Families (TANF) Application/Supplemental Nutrition Assistance Program (Snap) Application/Refugee Cash Assistance (Rca) Application" - South Carolina")
![DSS Form 1216 "Voluntary Child Support/Contribution Form" - South Carolina](https://data.templateroller.com/pdf_docs_html/2012/20120/2012039/dss-form-1216-voluntary-child-support-contribution-form-south-carolina.png "DSS Form 1216 "Voluntary Child Support/Contribution Form" - South Carolina")
![DSS Form 1211 "Request for Child Support Information" - South Carolina](https://data.templateroller.com/pdf_docs_html/2003/20038/2003864/dss-form-1211-request-for-child-support-information-south-carolina.png "DSS Form 1211 "Request for Child Support Information" - South Carolina")
![DSS Form 2056 "Psychotropic Medication Informed Consent" - South Carolina](https://data.templateroller.com/pdf_docs_html/1931/19313/1931353/dss-form-2056-psychotropic-medication-informed-consent-south-carolina.png "DSS Form 2056 "Psychotropic Medication Informed Consent" - South Carolina")
![DSS Form 3800 "Application for the Fi Program, Snap Program and Refugee Assistance (Ra) Program" - South Carolina](https://data.templateroller.com/pdf_docs_html/2049/20494/2049409/dss-form-3800-application-for-the-fi-program-snap-program-and-refugee-assistance-ra-program-south-carolina.png "DSS Form 3800 "Application for the Fi Program, Snap Program and Refugee Assistance (Ra) Program" - South Carolina")
![DSS Form 3072 "Consent to Release Information" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19175/1917583/dss-form-3072-consent-to-release-information-south-carolina.png "DSS Form 3072 "Consent to Release Information" - South Carolina")
![DSS Form 3809 "Simplified Renewal for the Elderly - Notice of Expiration" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19176/1917699/dss-form-3809-simplified-renewal-the-elderly-notice-expiration-south-carolina.png "DSS Form 3809 "Simplified Renewal for the Elderly - Notice of Expiration" - South Carolina")
![DSS Form 1645 "Application for Free and Reduced-Price Meals in Adult Care Food Programs" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19175/1917531/dss-form-1645-application-free-and-reduced-price-meals-in-adult-care-food-programs-south-carolina.png "DSS Form 1645 "Application for Free and Reduced-Price Meals in Adult Care Food Programs" - South Carolina")
![DSS Form 1531 "Foster Parent Agreement With Dss Regarding Placement of a Child" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19176/1917623/dss-form-1531-foster-parent-agreement-with-dss-regarding-placement-a-child-south-carolina.png "DSS Form 1531 "Foster Parent Agreement With Dss Regarding Placement of a Child" - South Carolina")
![DSS Form 3082 "Abandoned Infants Form for Safe Havens" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19175/1917511/dss-form-3082-abandoned-infants-form-safe-havens-south-carolina.png "DSS Form 3082 "Abandoned Infants Form for Safe Havens" - South Carolina")
![DSS Form 1205 "Declaration and Consent to Participate in the South Carolina Combined Application Project (Sccap)" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19175/1917592/dss-form-1205-declaration-and-consent-to-participate-in-the-south-carolina-combined-application-project-sccap-south-carolina.png "DSS Form 1205 "Declaration and Consent to Participate in the South Carolina Combined Application Project (Sccap)" - South Carolina")
![DSS Formulario 1620 "Formulario Para Reportar Cambios Simples" - South Carolina (Spanish)](https://data.templateroller.com/pdf_docs_html/1917/19176/1917620/dss-form-1620-spa-formulario-para-reportar-cambios-simples-south-carolina.png "DSS Formulario 1620 "Formulario Para Reportar Cambios Simples" - South Carolina (Spanish)")
![DSS Form 1620 "Change Report Form for Simplified Reporters" - South Carolina](https://data.templateroller.com/pdf_docs_html/1914/19148/1914877/dss-form-1620-change-report-form-for-simplified-reporters-south-carolina.png "DSS Form 1620 "Change Report Form for Simplified Reporters" - South Carolina")
![DSS Form 1214 "Informed Consent and Notification Regarding Psychotropic Medication" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19176/1917663/dss-form-1214-informed-consent-and-notification-regarding-psychotropic-medication-south-carolina.png "DSS Form 1214 "Informed Consent and Notification Regarding Psychotropic Medication" - South Carolina")
![DSS Form 3778 "Sc Voucher Program Family, Friend, and Neighbor Provider Health and Safety Grant Reimbursement Request" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19175/1917515/dss-form-3778-sc-voucher-program-family-friend-and-neighbor-provider-health-and-safety-grant-reimbursement-request-south-carolina.png "DSS Form 3778 "Sc Voucher Program Family, Friend, and Neighbor Provider Health and Safety Grant Reimbursement Request" - South Carolina")
![DSS Form 2601 "Civil Rights Discrimination Complaint Form" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19175/1917572/dss-form-2601-civil-rights-discrimination-complaint-form-south-carolina.png "DSS Form 2601 "Civil Rights Discrimination Complaint Form" - South Carolina")
![DSS Form 1326 "Notification of Eligibility Determination for Refugee Resettlement Program" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19176/1917662/dss-form-1326-notification-eligibility-determination-refugee-resettlement-program-south-carolina.png "DSS Form 1326 "Notification of Eligibility Determination for Refugee Resettlement Program" - South Carolina")
![DSS Form 2924 "Central Registry Release of Information and Compliance Statement" - South Carolina](https://data.templateroller.com/pdf_docs_html/1914/19147/1914711/dss-form-2924-central-registry-release-information-and-compliance-statement-south-carolina.png "DSS Form 2924 "Central Registry Release of Information and Compliance Statement" - South Carolina")
![DSS Form 3360 "Senior Farmers' Market Nutrition Program Application" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19176/1917694/dss-form-3360-senior-farmers-market-nutrition-program-application-south-carolina.png "DSS Form 3360 "Senior Farmers' Market Nutrition Program Application" - South Carolina")
![DSS Form 2909 "Family Child Care Home Consumer Parent Statement" - South Carolina](https://data.templateroller.com/pdf_docs_html/1914/19146/1914689/dss-form-2909-family-child-care-home-consumer-parent-statement-south-carolina.png "DSS Form 2909 "Family Child Care Home Consumer Parent Statement" - South Carolina")
![DSS Form 2922 "Original or Renewal Registration of Family Child Care Home (Fcch)" - South Carolina](https://data.templateroller.com/pdf_docs_html/1913/19134/1913405/dss-form-2922-original-or-renewal-registration-of-family-child-care-home-fcch-south-carolina.png "DSS Form 2922 "Original or Renewal Registration of Family Child Care Home (Fcch)" - South Carolina")
![DSS Form 1474 "Employee Exit Survey" - South Carolina](https://data.templateroller.com/pdf_docs_html/1917/19176/1917601/dss-form-1474-employee-exit-survey-south-carolina.png "DSS Form 1474 "Employee Exit Survey" - South Carolina")
![DSS Form 1574 "Medical Report for Prospective Foster/Adoptive Parent" - South Carolina](https://data.templateroller.com/pdf_docs_html/1914/19149/1914920/dss-form-1574-medical-report-prospective-foster-adoptive-parent-south-carolina.png "DSS Form 1574 "Medical Report for Prospective Foster/Adoptive Parent" - South Carolina")
![DSS Form 1572 "Intake and Application for Services" - South Carolina](https://data.templateroller.com/pdf_docs_html/1914/19146/1914693/dss-form-1572-intake-and-application-services-south-carolina.png "DSS Form 1572 "Intake and Application for Services" - South Carolina")
![DSS Formulario 1573 "Informacion Financiera" - South Carolina (Spanish)](https://data.templateroller.com/pdf_docs_html/1917/19176/1917635/dss-form-1573-spa-informacion-financiera-south-carolina.png "DSS Formulario 1573 "Informacion Financiera" - South Carolina (Spanish)")
