Form CFS1800-M-1 "Notice of Intent to Discontinue Subsidy Payments on 18th Birthday" - Illinois

What Is Form CFS1800-M-1?

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 May 1, 2011;
  • 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;

Download a fillable version of Form CFS1800-M-1 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 CFS1800-M-1 "Notice of Intent to Discontinue Subsidy Payments on 18th Birthday" - Illinois

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CFS 1800-M-1
State of Illinois
5/2011
Department of Children and Family Services
st
1
Notice
nd
2
Notice
Notice of Intent
th
To Discontinue Subsidy Payments on 18
Birthday
Date:
Child’s Name:
Child’s ID #:
Child’s Birthdate:
th
Child’s 18
Birthday:
Current Address On File:
th
birthday as stated in the terms of the assistance
The subsidy for your child is scheduled to end on his/her 18
agreement that you signed prior to the adoption or guardianship finalization.
If you believe that your child meets one of the following criteria at this time, he/she may be eligible for an
extension of the subsidy agreement.
Please read Option 1 and Option 2 very carefully and check one of the boxes if you believe that your child
qualifies for one of these options.
A CHILD MAY BE ELIGIBLE FOR ONLY ONE OF THESE OPTIONS.
OPTION 1: The above named child has a physical or mental disability that substantially limits one
or more of his/her major life activities. This disability or a risk factor for this
disability was identified prior to the finalization of his/her adoption or guardianship
and is documented in his/her subsidy agreement. You may be required to obtain and
submit documentation from a physician that addresses the limitations caused by the
disability.
OPTION 2: The above named child is attending high school and will not graduate before his/her
th
18
birthday.
He/She DOES NOT have a physical or mental disability that
substantially limits one or more of his/her major life activities. You will need to
submit a letter from the child’s high school verifying the child’s expected graduation
date.
If you have checked either box above, please return this form to your subsidy worker listed below by this
date:
.
IF A RESPONSE FROM YOU IS NOT RECEIVED BY THIS DATE, IT WILL BE DETERMINED
th
THAT THE CHILD’S 18
BIRTHDAY IS THE CORRECT TERMINATION DATE OF THEIR
SUBSIDY.
CFS 1800-M-1
State of Illinois
5/2011
Department of Children and Family Services
st
1
Notice
nd
2
Notice
Notice of Intent
th
To Discontinue Subsidy Payments on 18
Birthday
Date:
Child’s Name:
Child’s ID #:
Child’s Birthdate:
th
Child’s 18
Birthday:
Current Address On File:
th
birthday as stated in the terms of the assistance
The subsidy for your child is scheduled to end on his/her 18
agreement that you signed prior to the adoption or guardianship finalization.
If you believe that your child meets one of the following criteria at this time, he/she may be eligible for an
extension of the subsidy agreement.
Please read Option 1 and Option 2 very carefully and check one of the boxes if you believe that your child
qualifies for one of these options.
A CHILD MAY BE ELIGIBLE FOR ONLY ONE OF THESE OPTIONS.
OPTION 1: The above named child has a physical or mental disability that substantially limits one
or more of his/her major life activities. This disability or a risk factor for this
disability was identified prior to the finalization of his/her adoption or guardianship
and is documented in his/her subsidy agreement. You may be required to obtain and
submit documentation from a physician that addresses the limitations caused by the
disability.
OPTION 2: The above named child is attending high school and will not graduate before his/her
th
18
birthday.
He/She DOES NOT have a physical or mental disability that
substantially limits one or more of his/her major life activities. You will need to
submit a letter from the child’s high school verifying the child’s expected graduation
date.
If you have checked either box above, please return this form to your subsidy worker listed below by this
date:
.
IF A RESPONSE FROM YOU IS NOT RECEIVED BY THIS DATE, IT WILL BE DETERMINED
th
THAT THE CHILD’S 18
BIRTHDAY IS THE CORRECT TERMINATION DATE OF THEIR
SUBSIDY.
ANY EXTENSION OF THE SUBSIDY AGREEMENT MUST BE DETERMINED PRIOR TO THE
th
CHILD’S 18
BIRTHDAY AND IS CONSIDERED FINAL. A SUBSIDY AGREEMENT CANNOT BE
EXTENDED TO THE AGE OF 19 YEARS OR HIGH SCHOOL GRADUATION AND THEN FURTHER
EXTENDED TO THE AGE OF 21 YEARS FOR A PHYSICAL OR MENTAL DISABILITY.
th
You will receive final notice of your child’s subsidy termination date 60 days prior to your child’s 18
birthday.
Please contact your subsidy worker if you have any questions about this letter or process of subsidy
termination.
Subsidy Worker:
Address:
Phone:
Please confirm your current address and phone number below:
Name:
Address:
Phone:
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