Foster Care Placement Notification and Preliminary Eligibility Determination, SFN 630 447-10-70-05

(Revised 5/28/15 ML #3447)

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PI 18-17

 

 

SFN 630 is an official form designed to notify the eligibility staff that the child has entered foster care. The form is completed by the case manager and provides case specific information. A copy of the pertinent court documents should be attached when submitting to the eligibility worker. This form is used by the eligibility worker in conjunction with the SFN 641, Title IV-E Title XIX Application-Foster Care in determining foster care eligibility.

 

This form is available electronically via E-Forms.