Job & Family Services - Office of Fiscal Services
Bureau of County Finance and Technical Assistance ~ Forms

Forms

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These are the ODJFS forms currently referenced in the FAPM: 

JFS 01159 Transfer of Administration Allocation to Program Allocation
JFS 01160  Request for Transfer of WIA Funds
JFS 01161 Certification of TANF Incentive
JFS 01659  Title IV-E Auxiliary Payment Authorization
JFS 01794 Juvenile Court Random Moment Sample (RMS) Observation Form
JFS 01797  Juvenile Court Social Services Random Moment Allocation Quarterly Billing
JFS 01869 WIA Administrative Cost Allocation Administration and Direct Delivery
JFS 01870 Federal Medicaid and Federal Food Stamp Match Certification
JFS 01925  Monthly FCM Facility Invoice
JFS 01991  Annual TANF Incentives Expenditure Report
JFS 01992 Workforce Investment Act (WIA) Fund Certification Sheet
JFS 02531 Certification Sheet
JFS 02710  Income Maintenance Random Moment Sample (RMS) Observation
Form
JFS 02711 Workforce Random Moment Sample (RMS) Observation Form
JFS 02712 Child Support Random Moment Sample (RMS) Observation Form
JFS 02713 Request for Retroactive Coding Adjustment
JFS 02714 Social Services Random Moment Sample (RMS) Observation Form
JFS 02715 Child Welfare Random Moment Sample (RMS) Observation Form
JFS 02717  Annual Closeout Agreement and Certification Administrative Fund Reconciliation
JFS 02718  Notification of Intent to Participate in Inter-county Adjustment of Allocated Funds 
JFS 02719  Inter-county Agreement and Certification Release and Acceptance of Funds  
JFS 02730  Notice of Collection for OJFS Conducted County Audit
JFS 02737 Notice of Collection for State or Federally Conducted County Audit
JFS 02750  Child Support Administrative Fund Monthly Financial Statement
JFS 02820 Monthly Financial Statement Childrens Services Fund
JFS 02827  Monthly Financial Statement Public Assistance Fund Certification
Sheet
JFS 04200 Food Stamp Fraud Control Report
JFS 04230 Annual Cash Assistance Fraud Activity Report
JFS 04235  Income Eligibility Verification System (IEVS) Cost Report
JFS 04262 Children Receiving Child Welfare Services Provided by Public Agencies
JFS 04280  Title IV-E Foster Care Expenditure Report
JFS 04282  Social Services Block Grant Quarterly Summary Of Direct Services 
Provided and Purchased Services Contracts and Agreements
JFS 04284  Model 4284 - Monthly Provider Expenses In Performance of Title XX Purchased Services Contracts
JFS 04290  Quarterly Report of CDJFS Full Time Equivalent (FTE) Positions
JFS 04291 Quarterly Report of Stand Alone CSEA, PCSA, and WIA Full Time Equivalent (FTE) Positions