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DSSVS694 12/17Crime Victims Compensation Program
Primary Application
A program provided by the South Dakota
Department of Social Services to provide monetary
assistance to victims of violent crime.
Department
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How to fill out dss-vs-694 1217
01
To fill out the DSS-VS-694 1217 form, follow these steps:
02
Begin by entering the date on the designated field.
03
Enter the name of the individual for whom the form is being filled out.
04
Provide the individual's Social Security Number.
05
Indicate the individual's current address.
06
Fill in the contact information, such as phone number and email address.
07
Enter the date of birth of the individual.
08
Specify the gender of the individual.
09
Provide the race and ethnicity information.
10
Indicate the primary language spoken by the individual.
11
Mention any additional languages spoken by the individual.
12
Specify if the individual has a disability and provide relevant details if applicable.
13
Indicate if the individual is currently enrolled in school.
14
Mention the name of the school and provide contact information if applicable.
15
Provide information about the individual's birth parents.
16
Specify if the individual has siblings and provide their names and ages.
17
Provide information about any current or past child abuse or neglect allegations involving the individual.
18
Sign and date the form.
19
Review the completed form for accuracy and make any necessary corrections before submission.
Who needs dss-vs-694 1217?
01
The DSS-VS-694 1217 form may be needed by individuals who are involved with the Department of Social Services (DSS) or related social welfare agencies.
02
This form is typically used to gather relevant information about an individual for assessment, case management, and service provision purposes.
03
It may be required for various reasons, such as applying for benefits, undergoing evaluations, or participating in support programs.
04
Individuals who require assistance or resources from social services may need to fill out this form as part of the application or eligibility determination process.
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What is dss-vs-694 1217?
The DSS-VS-694 1217 is a form used for reporting specific information related to a certain program or activity.
Who is required to file dss-vs-694 1217?
Certain organizations or individuals involved in the program or activity are required to file the DSS-VS-694 1217.
How to fill out dss-vs-694 1217?
The DSS-VS-694 1217 form can be filled out by providing the requested information accurately and completely.
What is the purpose of dss-vs-694 1217?
The purpose of the DSS-VS-694 1217 form is to gather specific information for record-keeping and/or regulatory compliance.
What information must be reported on dss-vs-694 1217?
The DSS-VS-694 1217 form typically requires information such as names, dates, amounts, and other relevant details.
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