NC DSS 1404 2021-2025 free printable template

Care Management for At Risk Children (MARC)Internal Use: Date Referral Received:Referral Formulaic Target Population Birth to 5 YearsChilds Name: Referral Date (mm/dd/YYY): Date of Birth (mm/dd/YYY):

How to fill out cc4c referral form 2021-2025

How to fill out NC DSS 1404

1. Begin by downloading and printing NC DSS 1404 form.
2. Fill out your personal information at the top of the form, including your name, address, and contact information.
3. Indicate the type of assistance you are applying for by checking the appropriate boxes.
4. Provide detailed information about your household members, including their names, dates of birth, and Social Security numbers.
5. Include your employment information, such as your job title, employer's name, and hours worked.
6. Disclose any income sources, including wages, benefits, or other payments received.
7. List your living expenses to help determine your eligibility, including housing costs, utilities, and food expenses.
8. Review all the information for accuracy and completeness.
9. Sign and date the form to certify that all information provided is true.

Who needs NC DSS 1404?

1. Individuals or families seeking assistance from the North Carolina Department of Social Services.
2. People who qualify for public assistance programs such as food benefits, Medicaid, or childcare services.

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What is NC DSS 1404?

NC DSS 1404 is a form used by the North Carolina Department of Social Services to report specific financial information regarding child support payments.

Who is required to file NC DSS 1404?

Individuals or entities responsible for making child support payments in North Carolina are required to file NC DSS 1404.

How to fill out NC DSS 1404?

To fill out NC DSS 1404, provide details such as personal information, payment history, and any changes in income. Follow the instructions included with the form for accurate completion.

What is the purpose of NC DSS 1404?

The purpose of NC DSS 1404 is to ensure compliance with child support obligations and to keep accurate records for the state regarding these payments.

What information must be reported on NC DSS 1404?

Required information includes the payer's name, address, Social Security number, details of the child support order, payment amounts, and dates of payments made.