Form CFS152A "Children's Account Unit Assessment Form" - Illinois

What Is Form CFS152A?

This is a legal form that was released by the Illinois Department of Children and Family Services - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2004;
  • The latest edition provided by the Illinois Department of Children and Family Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CFS152A by clicking the link below or browse more documents and templates provided by the Illinois Department of Children and Family Services.

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Download Form CFS152A "Children's Account Unit Assessment Form" - Illinois

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CFS 152A
State of Illinois
3/2004
Department of Children and Family Services
Children’s Account Unit Assessment Form
Ward’s Name:
DCFS ID Number:
Current Placement
Name:
Address:
City, State, and Zip:
Permanency goal :
SGH
Adoption
Return Home
Independence
Is DCFS guardianship expected to end within 30 days?
Yes
No
Does the child have any special needs, currently or in the foreseeable future, that you believe could
be met with allowable expenditures from the child’s account?
Yes
No
IF YES, please provide a detailed explanation of the child’s disability and cause for requesting use of
these funds (attach additional pages if necessary).
Do you recommend allocation of the funds from the child’s account to provide services or purchase
items to meet these special needs?
Yes
No
IF YES, please complete and attach Disbursement Request Form and Disability Related Services
Report.
(
)
Case worker
Date
Telephone
Supervisor
Date
RETURN ALL FORMS TO:
Illinois Department of Children and Family Services
406 East Monroe Street, Mail Station 410
Springfield, IL 62701
or
FAX : 217-782-3882
CFS 152A
State of Illinois
3/2004
Department of Children and Family Services
Children’s Account Unit Assessment Form
Ward’s Name:
DCFS ID Number:
Current Placement
Name:
Address:
City, State, and Zip:
Permanency goal :
SGH
Adoption
Return Home
Independence
Is DCFS guardianship expected to end within 30 days?
Yes
No
Does the child have any special needs, currently or in the foreseeable future, that you believe could
be met with allowable expenditures from the child’s account?
Yes
No
IF YES, please provide a detailed explanation of the child’s disability and cause for requesting use of
these funds (attach additional pages if necessary).
Do you recommend allocation of the funds from the child’s account to provide services or purchase
items to meet these special needs?
Yes
No
IF YES, please complete and attach Disbursement Request Form and Disability Related Services
Report.
(
)
Case worker
Date
Telephone
Supervisor
Date
RETURN ALL FORMS TO:
Illinois Department of Children and Family Services
406 East Monroe Street, Mail Station 410
Springfield, IL 62701
or
FAX : 217-782-3882