CFS 403-2, Notice of Decision Instructions
This form contains 20 fields organized into 5 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Client Information | ||
| Client Name and Address | Text |
Provide the full name and complete mailing address of the client.
|
| Client Salutation | Text |
Enter the name of the client to whom the notice is addressed.
|
| Date of Notice | ||
| Date of Notice | Date |
Provide the date the notice was issued.
|
| Decision Details | ||
| Decision Description | Text |
Provide a detailed description of the decision(s) made regarding the recipient's involvement with the Department of Children and Family Services.
|
| Effective Date of Decision | Date |
Enter the date on which this decision or these decisions will become effective.
|
| Reasons for Decision | Text |
Explain the specific reasons why this decision or these decisions were made.
|
| Supporting Policy Citation | Text |
Provide the rule or procedure citation for the department policy that supports this decision or these decisions.
|
| General | ||
| Text4 | Text | |
| Text5 | Text | |
| Text6 | Text | |
| Text7 | Text | |
| Text8 | Text | |
| Text10 | Text | |
| Text11 | Text | |
| Text12 | Text | |
| Text13 | Text | |
| Text14 | Text | |
| Text15 | Text | |
| Page 2 | ||
| Worker's Telephone Number | Text |
Provide the telephone number for your worker.
|
| TDD Number | Text |
Provide the TDD telephone number for hearing-impaired individuals.
|