Form CFS490-15 "Interstate Placement Disruption Agreement" - Illinois

What Is Form CFS490-15?

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 June 1, 2015;
  • 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 CFS490-15 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 CFS490-15 "Interstate Placement Disruption Agreement" - Illinois

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CFS 490-15
6/2015
State of Illinois
Department of Children and Family Services
INTERSTATE ON THE PLACEMENT OF CHILDREN
PLACEMENT DISRUPTION AGREEMENT
Child’s ID Number:
In the event the placement of this child,
at
disrupts,
the
Parent(s)/
Guardian
is/are responsible for his/her
immediate return to the sending state of
.
Signature of Parent or Guardian:
Printed Name
Signature
Date
Signature of Other Person Responsible for the return of Child:
Printed Name
Signature
Date
Relationship to the Child:
The signature (i.e., parent, guardian, probation officer, school district official) of
person/agency/state responsible for return of child, if placement disrupts, is required.
CFS 490-15
6/2015
State of Illinois
Department of Children and Family Services
INTERSTATE ON THE PLACEMENT OF CHILDREN
PLACEMENT DISRUPTION AGREEMENT
Child’s ID Number:
In the event the placement of this child,
at
disrupts,
the
Parent(s)/
Guardian
is/are responsible for his/her
immediate return to the sending state of
.
Signature of Parent or Guardian:
Printed Name
Signature
Date
Signature of Other Person Responsible for the return of Child:
Printed Name
Signature
Date
Relationship to the Child:
The signature (i.e., parent, guardian, probation officer, school district official) of
person/agency/state responsible for return of child, if placement disrupts, is required.