FC Emergency Funds Authorization.pdf
PDF 180 KB Posted
- Attached to
- Master Agreement AZ|CTR055548
- Contract number
- CTR055548
- Issued by
- Arizona
About this file
This document is an Emergency Funds Authorization form from Family Connections, a social service organization. The form is designed for requesting emergency financial assistance, with fields for agency details, case person information, and a DCS (Department of Child Services) specialist's approval. The form provides a structured template for documenting emergency funding needs, including specific items, amounts, and justifications.
The form includes sections for listing multiple emergency fund items with corresponding amounts and justification of need, culminating in a total amount field. It also includes a team section for an FC (Family Connections) Consultant and Supervisor, with space for their contact phone numbers. The document appears to be a standardized internal process for quickly authorizing and tracking emergency financial support for individuals or families in crisis, though no specific funding amounts or details are filled in on this blank template.
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Text version
Family Connections
EMERGENCY FUNDS AUTHORIZATION
Agency:
Date of Request:
Case Person:
Person ID:
DCS Specialist:
Approval Date: Time:
EMERGENCY FUNDS NEEDED:
Item Amount Justification of Need
Total Amount
TEAM
FC Consultant: Phone:
FC Supervisor: Phone:
File details come from the government source that posted it. Updated .