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54
![Form HS-3489 "Ssbg Refusal of Services" - Tennessee](https://data.templateroller.com/pdf_docs_html/2138/21384/2138462/form-hs-3489-ssbg-refusal-of-services-tennessee.png "Form HS-3489 "Ssbg Refusal of Services" - Tennessee")
![Form HS-3299 "Criminal Background Check Transfer" - Tennessee](https://data.templateroller.com/pdf_docs_html/2120/21204/2120466/form-hs-3299-criminal-background-check-transfer-tennessee.png "Form HS-3299 "Criminal Background Check Transfer" - Tennessee")
![Form HS-3288 "Pre-employment Transition Services Permission" - Tennessee](https://data.templateroller.com/pdf_docs_html/2109/21093/2109339/form-hs-3288-pre-employment-transition-services-permission-tennessee.png "Form HS-3288 "Pre-employment Transition Services Permission" - Tennessee")
![Form HS-3475 "Ssbg Authorized Signatories Form" - Tennessee](https://data.templateroller.com/pdf_docs_html/2109/21093/2109338/form-hs-3475-ssbg-authorized-signatories-form-tennessee.png "Form HS-3475 "Ssbg Authorized Signatories Form" - Tennessee")
![Form HS-3470 "Specific Assistance to Individuals Only Recipient Notice" - Tennessee](https://data.templateroller.com/pdf_docs_html/2091/20918/2091814/form-hs-3470-specific-assistance-to-individuals-only-recipient-notice-tennessee.png "Form HS-3470 "Specific Assistance to Individuals Only Recipient Notice" - Tennessee")
![Form HS-3109 "Ssbg Change in Circumstances" - Tennessee](https://data.templateroller.com/pdf_docs_html/2089/20897/2089764/form-hs-3109-ssbg-change-in-circumstances-tennessee.png "Form HS-3109 "Ssbg Change in Circumstances" - Tennessee")
![Form HS-3463 "Tennessee Ssbg Contract Budget Revision" - Tennessee](https://data.templateroller.com/pdf_docs_html/2069/20696/2069653/form-hs-3463-tennessee-ssbg-contract-budget-revision-tennessee.png "Form HS-3463 "Tennessee Ssbg Contract Budget Revision" - Tennessee")
![Form HS-2978 "Transmittal Authorization" - Tennessee](https://data.templateroller.com/pdf_docs_html/2036/20368/2036899/form-hs-2978-transmittal-authorization-tennessee.png "Form HS-2978 "Transmittal Authorization" - Tennessee")
![Form HS-0169 "Family Assistance Application" - Tennessee](https://data.templateroller.com/pdf_docs_html/2049/20494/2049408/form-hs-0169-family-assistance-application-tennessee.png "Form HS-0169 "Family Assistance Application" - Tennessee")
![Form HS-3408 "Application for Child Care Payment Assistance/Smart Steps" - Tennessee](https://data.templateroller.com/pdf_docs_html/2049/20496/2049614/form-hs-3408-application-for-child-care-payment-assistance-smart-steps-tennessee.png "Form HS-3408 "Application for Child Care Payment Assistance/Smart Steps" - Tennessee")
![Form HS-2997 "Request for Administrative Hearing" - Tennessee](https://data.templateroller.com/pdf_docs_html/1919/19190/1919002/form-hs-2997-request-administrative-hearing-tennessee.png "Form HS-2997 "Request for Administrative Hearing" - Tennessee")
![Form HS-2755 "Client Complaint" - Tennessee](https://data.templateroller.com/pdf_docs_html/1919/19190/1919005/form-hs-2755-client-complaint-tennessee.png "Form HS-2755 "Client Complaint" - Tennessee")
![Form HS-3003 "Affidavit Request for Snap Replacements Due to Household Misfortune and Power Outage" - Tennessee](https://data.templateroller.com/pdf_docs_html/2069/20696/2069648/form-hs-3003-affidavit-request-for-snap-replacements-due-to-household-misfortune-and-power-outage-tennessee.png "Form HS-3003 "Affidavit Request for Snap Replacements Due to Household Misfortune and Power Outage" - Tennessee")
![Formulario HS-3003 "Declaracion Jurada De Solicitud De Restitucion De Snap Debido a Una Adversidad E Interrupcion Del Servicio Electrico Del Nucleo Familiar" - Tennessee (Spanish)](https://data.templateroller.com/pdf_docs_html/2069/20696/2069649/formulario-hs-3003-declaracion-jurada-de-solicitud-de-restitucion-de-snap-debido-a-una-adversidad-e-interrupcion-del-servicio-electrico-del-nucleo-familiar-tennessee-spanish.png "Formulario HS-3003 "Declaracion Jurada De Solicitud De Restitucion De Snap Debido a Una Adversidad E Interrupcion Del Servicio Electrico Del Nucleo Familiar" - Tennessee (Spanish)")
![Form HS-2939 "HIPAA Authorization for Release of Medical/Health Information to 3rd Party" - Tennessee](https://data.templateroller.com/pdf_docs_html/1919/19190/1919009/form-hs-2939-hipaa-authorization-release-medical-health-information-to-3rd-party-tennessee.png "Form HS-2939 "HIPAA Authorization for Release of Medical/Health Information to 3rd Party" - Tennessee")
![Form HS-3082 "External Data Request" - Tennessee](https://data.templateroller.com/pdf_docs_html/1919/19190/1919004/form-hs-3082-external-data-request-tennessee.png "Form HS-3082 "External Data Request" - Tennessee")
![Form HS-2633 "Withdrawal of Civil Rights Complaint" - Tennessee (Arabic)](https://data.templateroller.com/pdf_docs_html/1919/19190/1919006/form-hs-2633-withdrawal-civil-rights-complaint-tennessee.png "Form HS-2633 "Withdrawal of Civil Rights Complaint" - Tennessee (Arabic)")
![Form HS-2938 "General Authorization for Release of Information by the Tennessee Department of Human Services to a 3rd Party" - Tennessee](https://data.templateroller.com/pdf_docs_html/1913/19132/1913212/form-hs-2938-general-authorization-for-release-of-information-by-the-tennessee-department-of-human-services-to-a-3rd-party-tennessee.png "Form HS-2938 "General Authorization for Release of Information by the Tennessee Department of Human Services to a 3rd Party" - Tennessee")
![Form HS-3194 "Summer Food Service Program Income Excess Funds Form" - Tennessee](https://data.templateroller.com/pdf_docs_html/1913/19132/1913215/form-hs-3194-summer-food-service-program-income-excess-funds-form-tennessee.png "Form HS-3194 "Summer Food Service Program Income Excess Funds Form" - Tennessee")
Form HS-3194 "Summer Food Service Program Income Excess Funds Form" - Tennessee
Size: 155 KB
2 pages
![Form HS-3191 "Child and Adult Care Food Program Monthly Racial and Ethnic Data" - Tennessee](https://data.templateroller.com/pdf_docs_html/1918/19189/1918998/form-hs-3191-child-and-adult-care-food-program-monthly-racial-and-ethnic-data-tennessee.png "Form HS-3191 "Child and Adult Care Food Program Monthly Racial and Ethnic Data" - Tennessee")
![Form HS-3069 "Claim for Reimbursement Child and Adult Care Food Program" - Tennessee](https://data.templateroller.com/pdf_docs_html/1913/19132/1913217/form-hs-3069-claim-for-reimbursement-child-and-adult-care-food-program-tennessee.png "Form HS-3069 "Claim for Reimbursement Child and Adult Care Food Program" - Tennessee")
Form HS-3069 "Claim for Reimbursement Child and Adult Care Food Program" - Tennessee
Size: 349 KB
2 pages
![Form HS-3083 "Claim for Reimbursement Child and Adult Care Food Program (Homes Only)" - Tennessee](https://data.templateroller.com/pdf_docs_html/1913/19132/1913218/form-hs-3083-claim-for-reimbursement-child-and-adult-care-food-program-homes-only-tennessee.png "Form HS-3083 "Claim for Reimbursement Child and Adult Care Food Program (Homes Only)" - Tennessee")
![Form HS-3071 "Claim for Reimbursement" - Tennessee](https://data.templateroller.com/pdf_docs_html/1913/19132/1913214/form-hs-3071-claim-for-reimbursement-tennessee.png "Form HS-3071 "Claim for Reimbursement" - Tennessee")
![Form HS-2937 "Parent/Guardian Authorization for the Tennessee Department of Education or Local Education Agency to Release School Attendance Records" - Tennessee](https://data.templateroller.com/pdf_docs_html/1913/19132/1913211/form-hs-2937-parent-guardian-authorization-for-the-tennessee-department-of-education-or-local-education-agency-to-release-school-attendance-records-tennessee.png "Form HS-2937 "Parent/Guardian Authorization for the Tennessee Department of Education or Local Education Agency to Release School Attendance Records" - Tennessee")
![Form HS-2940 "General Authorization for Release of Information to the Tennessee Department of Human Services" - Tennessee](https://data.templateroller.com/pdf_docs_html/1913/19132/1913213/form-hs-2940-general-authorization-for-release-of-information-to-the-tennessee-department-of-human-services-tennessee.png "Form HS-2940 "General Authorization for Release of Information to the Tennessee Department of Human Services" - Tennessee")
![Form HS-3006 "Child Care Family or Group Home Documentation: Use of Developmental Learning Standards" - Tennessee](https://data.templateroller.com/pdf_docs_html/1913/19131/1913175/form-hs-3006-child-care-family-or-group-home-documentation-use-of-developmental-learning-standards-tennessee.png "Form HS-3006 "Child Care Family or Group Home Documentation: Use of Developmental Learning Standards" - Tennessee")
![Form HS-3468 "Aps Confidentiality and Nondisclosure Agreement Letter" - Tennessee](https://data.templateroller.com/pdf_docs_html/2104/21048/2104882/form-hs-3468-aps-confidentiality-and-nondisclosure-agreement-letter-tennessee.png "Form HS-3468 "Aps Confidentiality and Nondisclosure Agreement Letter" - Tennessee")
![Instructions for Form HS-3288 "Pre-employment Transition Services Permission" - Tennessee](https://data.templateroller.com/pdf_docs_html/2104/21048/2104885/instructions-for-form-hs-3288-pre-employment-transition-services-permission-tennessee.png "Instructions for Form HS-3288 "Pre-employment Transition Services Permission" - Tennessee")
![Instructions for Form HS-3470 "Specific Assistance to Individuals Only Recipient Notice" - Tennessee](https://data.templateroller.com/pdf_docs_html/2089/20897/2089765/instructions-for-form-hs-3470-specific-assistance-to-individuals-only-recipient-notice-tennessee.png "Instructions for Form HS-3470 "Specific Assistance to Individuals Only Recipient Notice" - Tennessee")
![Instructions for Form HS-3460 "Ssbg Corrective Action Plan" - Tennessee](https://data.templateroller.com/pdf_docs_html/2089/20897/2089763/instructions-for-form-hs-3460-ssbg-corrective-action-plan-tennessee.png "Instructions for Form HS-3460 "Ssbg Corrective Action Plan" - Tennessee")
![Instructions for Form HS-3456 "Specific Assistance Request" - Tennessee](https://data.templateroller.com/pdf_docs_html/2069/20696/2069652/instructions-for-form-hs-3456-specific-assistance-request-tennessee.png "Instructions for Form HS-3456 "Specific Assistance Request" - Tennessee")
![Instructions for Form HS-3475 "Ssbg Authorized Signatories Form" - Tennessee](https://data.templateroller.com/pdf_docs_html/2104/21048/2104884/instructions-for-form-hs-3475-ssbg-authorized-signatories-form-tennessee.png "Instructions for Form HS-3475 "Ssbg Authorized Signatories Form" - Tennessee")
![Instructions for Form HS-3465 "Community and Social Services Invoice for Reimbursement" - Tennessee](https://data.templateroller.com/pdf_docs_html/2104/21048/2104883/instructions-for-form-hs-3465-community-and-social-services-invoice-for-reimbursement-tennessee.png "Instructions for Form HS-3465 "Community and Social Services Invoice for Reimbursement" - Tennessee")
![Instructions for Form HS-3003 "Request for Food Stamp Replacement Due to Household Misfortune" - Tennessee](https://data.templateroller.com/pdf_docs_html/1918/19189/1918991/request-food-stamp-replacement-due-to-household-misfortune.png "Instructions for Form HS-3003 "Request for Food Stamp Replacement Due to Household Misfortune" - Tennessee")
![Instructions for Form HS-3117 "Application for Social Services Block Grant (Ssbg) Services" - Tennessee](https://data.templateroller.com/pdf_docs_html/2069/20696/2069651/instructions-for-form-hs-3117-application-for-social-services-block-grant-ssbg-services-tennessee.png "Instructions for Form HS-3117 "Application for Social Services Block Grant (Ssbg) Services" - Tennessee")
![Form HS-2939A "HIPAA Authorization for Release of Medical/Health Information to a 3rd Party" - Tennessee (Arabic)](https://data.templateroller.com/pdf_docs_html/1919/19190/1919016/form-hs-2939a-hipaa-authorization-release-medical-health-information-to-a-3rd-party-tennessee.png "Form HS-2939A "HIPAA Authorization for Release of Medical/Health Information to a 3rd Party" - Tennessee (Arabic)")
![Form HS-2939S "HIPAA Authorization for Release of Medical/Health Information to a 3rd Party" - Tennessee (Somali)](https://data.templateroller.com/pdf_docs_html/1919/19190/1919012/form-hs-2939s-hipaa-authorization-for-release-of-medical-health-information-to-a-3rd-party-tennessee-somali.png "Form HS-2939S "HIPAA Authorization for Release of Medical/Health Information to a 3rd Party" - Tennessee (Somali)")
![Formulario HS-2634S "Formulario Para Apelacion De Queja De Derechos Civiles" - Tennessee (Spanish)](https://data.templateroller.com/pdf_docs_html/1918/19189/1918993/form-hs-2634s-formulario-para-apelacion-de-queja-de-derechos-civiles-tennessee.png "Formulario HS-2634S "Formulario Para Apelacion De Queja De Derechos Civiles" - Tennessee (Spanish)")
![Formulario HS-2937S "Autorizacion Del Padre, La Madre O El Tutor Para Que El Departamento De Educacion De Tennessee O La Institucion Educativa Local Divulgue Registros De Asistencia Escolar" - Tennessee (Spanish)](https://data.templateroller.com/pdf_docs_html/1919/19190/1919011/form-hs-2937s-autorizacion-del-padre-la-madre-o-el-tutor-para-que-el-departamento-de-educacion-de-tennessee-o-la-institucion-educativa-local-divulgue-registros-de-asistencia-escolar-tennessee.png "Formulario HS-2937S "Autorizacion Del Padre, La Madre O El Tutor Para Que El Departamento De Educacion De Tennessee O La Institucion Educativa Local Divulgue Registros De Asistencia Escolar" - Tennessee (Spanish)")
![Formulario HS-2940S "Autorizacion General Para Divulgacion De Informacion Al Departamento De Servicios Humanos De Tennessee" - Tennessee (Spanish)](https://data.templateroller.com/pdf_docs_html/1919/19190/1919021/form-hs-2940s-autorizacion-general-para-divulgacion-de-informacion-al-departamento-de-servicios-humanos-de-tennessee-tennessee.png "Formulario HS-2940S "Autorizacion General Para Divulgacion De Informacion Al Departamento De Servicios Humanos De Tennessee" - Tennessee (Spanish)")
