CFS 1800-U, 60+ Subsidy Checklist Instructions

Check this box if the final judgment for the adoption case has been obtained and is clerk stamped.

Check this box if the CFS 1410-PA form for case registration/case opening has been completed on the adoptive family.

Check this box if the CFS 906-E form for adoption assistance opening has been completed.

Please provide the full name of the Adoption Coordinator who reviewed the subsidy and case record content.

Please provide the date when the Adoption Coordinator reviewed the subsidy and case record content.

Please provide the printed name of the caseworker supervisor.

Please provide the full name and address of the agency.

Please provide the phone number of the caseworker supervisor.

Check this box if all requirements for Special Needs Documentation Item 2, including child age verification, birth certificate, and professional documentation, have been met. Fill only if 'CFS 1800-A-A Adoption Assistance Eligibility Determination' is 'Yes'.

Check this box if the child's age is verified as one or older and a copy of the Birth Certificate is included. Fill only if 'CFS 1800-A-A Adoption Assistance Eligibility Determination' is 'Yes'.

Check this box if professional documentation, such as psychological reports or medical records, is included. Fill only if 'CFS 1800-A-A Adoption Assistance Eligibility Determination' is 'Yes'.

Please provide the full name of the child's adoption case.

Please enter the CYCIS ID associated with the child's adoption case.

Enter the full name of the child in foster care.

Provide the CYCIS identification number for the child.

Provide the SACWIS identification number for the child.

Check this box if there is documentation from the Social Security Administration confirming the child's eligibility for SSI when the adoption petition was filed.

Check this box if copies of CM07 and CM24 from the Adoption liaison show the child was previously adopted and subsidized with Title IV-E funds.

Check this box if copies of the minor parent's CM24, CM08, and CR08 from the Adoption liaison document the child is from a IV-E eligible minor parent who received foster care maintenance payments.

Check this box if the CFS 1425 Change of Status document, indicating case closure, is included.

Check this box if the CFS 906-E Final Living Arrangement document, confirming the child's biological case is closed, is included.

Check this box if the ACR notification to cancel subsequent reviews has been provided.

Check this box if the Juvenile Court Case has been closed to allow for the Post Adoption assistance case to be opened.

Check this box if Consent by Agency to Adoption (CFS 436-1-A or CFS 436-A) is included.

Check this box if Entry of Appearance (CFS 436-2) is included.

Check this box if Affidavit of Agency (CFS 427) is included.

Check this box if Special Needs Certification (CFS 482-B) is included. Fill only if 'Professional documentation' is 'Yes'.

Check this box if Petition for Discharge from Guardianship (CFS 440), as applicable to regional court practice, is included.

Check this box if the Order for Discharge (CFS 440-1), for the Judge to sign at hearing and as applicable to regional court practice, is included.

Check this box if Interstate compact approval is included and applicable.

Check this box if documentation related to the Indian Child Welfare Act (ICWA) is provided for a child of Native American heritage.

Check this box if the CFS 458-B Relative Resources and Positive Supports Worksheet is provided.

Check this box if the CFS 484 Adoption/Guardianship Tracking Form is provided.

Check this box if a prior subsidy packet is provided, including subsidy paperwork, special needs documentation, financial documentation, and legal documents, applicable only for POST ADOPT cases.

Check this box if you have included one copy of the CFS 1800-PAGS, Post Adoption & Guardianship Services Acknowledgement.

Check this box if you have included one copy of the Initial and Final Reports of Investigation for Adoption CFS 411-A, ensuring the final report was completed within the last four months, and including the Back-Up Plan.

Check this box if you have included one copy of the background check results for all household members, ensuring they are dated within the appropriate timeframes as specified for licensed or unlicensed providers.

Check this box if you have included one copy of the New CFS 2000 Part 1 and II, Day Care Application, signed and dated by all, when requesting employment-related day care for children under age 3.

Check this box if you have included one copy of the CFS 1800-U, 60+ Subsidy Checklist, including the CFS 604.

Check this box if the ALS - 1 Child Registration Form is being provided. Fill only if 'CFS 1800-A-A Adoption Assistance Eligibility Determination' is 'Yes'.

Check this box if Case Notes or a Case Plan documenting the caseworker's search for adoptive placement resources or checking waiting lists of adoptive parents is being provided. Fill only if 'CFS 1800-A-A Adoption Assistance Eligibility Determination' is 'Yes'.

Check this box if documentation is provided confirming the caseworker inquired if prospective adoptive parents are willing to adopt without a subsidy (e.g., Adoptive Home Study, Conversion Home Study, and CFS 1800 B-A signed on page 7). Fill only if 'CFS 1800-A-A Adoption Assistance Eligibility Determination' is 'Yes'.

Check this box if documentation is provided stating that placing the child without a subsidy would be against their best interest due to significant emotional attachment (e.g., Investigatory Report or Adoption Conversion Summary). Fill only if 'CFS 1800-A-A Adoption Assistance Eligibility Determination' is 'Yes'.

Check this box once you have included the CFS 1800-A-A or CFS 1800-A-1 Adoption Assistance Eligibility Determination (with 3 original signatures) in the subsidy paperwork submission.

Check this box once you have included the CFS 1800-B-A Adoption Assistance Application, signed and dated by a parent (with 3 original signatures), in the subsidy paperwork submission.

Check this box once you have included the CFS 1800-C-A Adoption Assistance Agreement, signed and dated by adoptive parents and Caseworker Supervisor prior to Final Judgment (with 3 original signatures), in the subsidy paperwork submission.

Check this box once you have included the CFS 1800 D form (1 original and 2 copies) in the subsidy paperwork submission.

Check this box once you have included the CFS 470-H Affidavit (1 original and 2 copies) in the subsidy paperwork submission.

Check this box once you have included the CFS 1800-P Verification of Ongoing Monthly Subsidy Payment Amount (3 copies) in the subsidy paperwork submission.

Check this box once you have included the CFS 1800-SC Post Permanency Sibling Contact Agreement (3 copies), if applicable, in the subsidy paperwork submission.

Check this box once you have included the email from the Benefit Check Subsidies mailbox verifying whether the child is receiving any social security benefits (3 copies) in the subsidy paperwork submission.

Check this box if you have a copy of all relevant termination orders, surrenders, consents, or death certificates for the mother and all legal fathers, including proof for putative fathers and case notes for expedited adoptions without termination on both parents, acquired and submitted by the worker. Fill only if 'CFS 1800-A-A Adoption Assistance Eligibility Determination' is 'Yes'.