Get the free ICPC Form 100A - Children and Family Services Division - childsworld ca

One form per child Please type CPC 100A REV. 8/2001 INTERSTATE COMPACT ON THE PLACEMENT OF CHILDREN REQUEST FROM: TO: Notice is given of intent to place Name of Child: SECTION — IDENTIFYING DATA

How to fill out icpc form 100a

How to fill out ICPC Form 100A?

1. Start by obtaining a copy of ICPC Form 100A, which is used for requesting the placement of a child across state lines.
2. Fill in the header section of the form, providing the name of the sending agency, the date the form is completed, and the name and contact information of the person completing the form.
3. In the "Child's Information" section, enter the child's full name, date of birth, gender, and social security number (if available).
4. Fill in the "Requesting Agency" section, providing the name, address, and contact information of the sending agency responsible for the child.
5. Enter the "Receiving Agency" information, including the name, address, and contact details of the agency that will be responsible for the child in the receiving state.
6. Specify the type of placement being requested, whether it is for pre-placement or for an actual placement of the child.
7. Indicate the proposed duration of the placement, whether it is for a specific period of time or for an indefinite period.
8. Provide details about the child's current living arrangements, such as whether they are in foster care, with relatives, or in a residential treatment facility.
9. If the child has any known medical conditions or special needs, list them in the "Special Needs" section.
10. Next, detail the reasons for the requested placement and any specific services or resources that are being sought in the receiving state.
11. Sign and date the form, and make sure to include any required attachments or supporting documentation as specified by your state's ICPC office.
12. Keep a copy of the completed form for your records before submitting it to the appropriate ICPC office.

Who needs ICPC Form 100A?

1. ICPC Form 100A is required for any agency or individual seeking to place a child across state lines within the United States.
2. It is necessary for sending agencies, such as child welfare departments or private adoption agencies, who are responsible for the child's welfare in the sending state.
3. Receiving agencies, which may include child welfare agencies or prospective adoptive families, also need to complete this form to indicate their willingness and ability to accept the child in the receiving state.

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What is icpc form 100a?

ICPC Form 100A is a document used for the Interstate Compact on the Placement of Children to request approval for the out-of-state placement of a child.

Who is required to file icpc form 100a?

Any individual or entity seeking to place a child in another state is required to file ICPC Form 100A.

How to fill out icpc form 100a?

ICPC Form 100A must be completed by providing information about the child, the sending agency, the receiving agency, and the purpose of the placement.

What is the purpose of icpc form 100a?

The purpose of ICPC Form 100A is to ensure the safe and appropriate placement of children across state lines.

What information must be reported on icpc form 100a?

Information reported on ICPC Form 100A includes details about the child's background, the sending and receiving agencies, and the reason for the placement.