This form contains 42 fields organized into 8 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Caseworker Supervisor Information
Supervisor's Printed Name	Text	Enter the printed name of the caseworker supervisor.
Agency Name and Address	Text	Provide the full name and complete address of the agency.
Phone Number	Text	Enter the caseworker supervisor's phone number.
Child Information
Child's Name	Text	Please provide the full name of the child.
CYCIS ID	Text	Please enter the child's CYCIS identification number.
SACWIS ID	Text	Please enter the child's SACWIS identification number.
Remaining Documents Checklist
CFS 1800-PAGS, Post Adoption & Guardianship Services Acknowledgement	Checkbox	Check this box if the CFS 1800-PAGS, Post Adoption & Guardianship Services Acknowledgement (1 copy) is included.
Initial and Final Reports of Investigation for Guardianship - CFS 411-G	Checkbox	Check this box if the Initial and Final Reports of Investigation for Guardianship - CFS 411-G, completed within the last 4 months, including the Back-Up Plan (1 copy), is included.
CFS 483 Caseworker Permanency Planning Checklist	Checkbox	Check this box if the CFS 483 Caseworker Permanency Planning Checklist (1 copy) is included.
CFS 483-1 Caregiver Permanency Planning Checklist	Checkbox	Check this box if the CFS 483-1 Caregiver Permanency Planning Checklist (1 copy) is included.
CFS 484 Adoption/Guardianship Tracking Form	Checkbox	Check this box if the CFS 484 Adoption/Guardianship Tracking Form (1 copy) is included.
Results from background checks	Checkbox	Check this box if results from the background checks dated within the appropriate timeframes are included (1 copy), covering household members aged 13-17 (CANTS/SOR within 2 years of subsidy approval) and household members aged 18 and older (CANTS/SOR/ISP/FBI within 2 years of subsidy approval).
Certified copy of Birth Certificate	Checkbox	Check this box if a certified copy of the Birth Certificate (1 copy) is included.
ICWA documentation if child of Native American heritage	Checkbox	Check this box if ICWA documentation (1 copy) is included, applicable if the child is of Native American heritage.
CFS 458-B Relative Resources and Positive Supports Worksheet	Checkbox	Check this box if the CFS 458-B Relative Resources and Positive Supports Worksheet (1 copy) is included.
Social History/SACWIS Integrated Assessment Report (INITIAL)	Checkbox	Check this box if the Social History/SACWIS Integrated Assessment Report (INITIAL - 1 copy) is included.
SACWIS Client Service Plan	Checkbox	Check this box if the most recent SACWIS Client Service Plan, showing SG as a goal (1 copy), is included.
Required Documents Checklist
Temporary Custody Order	Checkbox	Check this box if the Temporary Custody Order (1 copy) is included in the packet.
Adjudicatory Order	Checkbox	Check this box if the Adjudicatory Order (1 copy) is included in the packet.
Dispositional Order	Checkbox	Check this box if the Dispositional Order (1 copy) is included in the packet.
Professional Documentation	Checkbox	Check this box if professional documentation, including psychological reports, medical reports, or other medical records (1 copy), is included in the packet.
New CFS 2000 Part 1 and II, Day Care Application	Checkbox	Check this box if the New CFS 2000 Part 1 and II, Day Care Application, signed and dated by all, is included when requesting for Employment Related Day Care for Children Under Age 3 (1 copy). Fill only if 'requesting for Employment Related Day Care for Children Under Age 3' is 'Yes'.
CFS 1800-U, 60+ Subsidy Checklist	Checkbox	Check this box if the CFS 1800-U, 60+ Subsidy Checklist, including form CFS 604 (1 copy), is included in the packet.
Subsidy Packet Checklist
Check Box44	CheckBox
Check Box45	CheckBox
Check Box46	CheckBox
Check Box47	CheckBox
Check Box48	CheckBox
Check Box49	CheckBox
Check Box50	CheckBox
Check Box51	CheckBox
Subsidy Packet Components
CFS 1800 A-G Eligibility	Checkbox	Check this box if the CFS 1800 A-G Eligibility form (3 originals) is included in the subsidy packet.
CFS 1800 B-G Application	Checkbox	Check this box if the CFS 1800 B-G Application form (3 originals) is included in the subsidy packet.
CFS 1800 C-G Agreement	Checkbox	Check this box if the CFS 1800 C-G Agreement form (3 originals) is included in the subsidy packet.
CFS 1800 D	Checkbox	Check this box if the CFS 1800 D form (1 original and 2 copies) is included in the subsidy packet and is applicable.
CFS 470-H Information Disclosure Form	Checkbox	Check this box if the CFS 470-H Information Disclosure Form (1 original and 2 copies) is included in the subsidy packet.
CFS 1800 P Verification of Monthly Subsidy Payment Amount	Checkbox	Check this box if the CFS 1800 P Verification of Monthly Subsidy Payment Amount form (3 copies) is included in the subsidy packet.
Email from Benefit Check Subsidies mailbox	Checkbox	Check this box if the email from the Benefit Check Subsidies mailbox verifying the child's Title IV-E Eligibility/Benefit Information (3 copies) is included in the subsidy packet.
CFS 1800-SC, Post Permanency Sibling Contact Agreement	Checkbox	Check this box if the CFS 1800-SC, Post Permanency Sibling Contact Agreement (3 copies) is included in the subsidy packet and is applicable.
The subsidy and case record content has been reviewed by:
Adoption Coordinator Name	Text	Please provide the name of the Adoption Coordinator who reviewed the subsidy and case record content.
Adoption Coordinator Review Date	Date	Please enter the date when the Adoption Coordinator reviewed the subsidy and case record content. Fill only if 'Adoption Coordinator Name' is filled. Depends on: Adoption Coordinator Name
Worker Information
Worker's Name or Number	Text	Enter the name or identification number of the worker.

CFS 1800-U, 60+ Subsidy Checklist Instructions