10848_ITN_Exhibit 3_Youth_Discharge_Form.pdf

This document is a Sample Youth Discharge Form related to ITN #10848. The form is used to document the discharge of youth from a program, including the youth's name, JJIS number, admission date, and discharge date. The form requires the signature of the program instructor. If services are not rendered within a 30-day period, the youth will be released or discharged from the program. The Youth Discharge form, along with a properly prepared invoice, must be submitted to the Department's Contract Manager within 15 business days following the end of the month for which services were rendered.

The document does not provide any information about pricing terms, set asides, incumbents, funding requirements and sources, or other salient contract details. It focuses solely on the administrative requirements for discharging youth from the program.