FC Emergency Funds Authorization.pdf
PDF 180 KB Posted
- Attached to
- Master Agreement AZ|CTR055524
- Contract number
- CTR055524
- Issued by
- Arizona
About this file
This document is a blank Emergency Funds Authorization form from Family Connections, designed for use by a Department of Child Services (DCS) agency. The form provides a template for requesting and documenting emergency financial assistance, with designated fields for agency information, case details, and approval tracking.
The form is structured to capture specific emergency funding needs, including itemized expenses, individual amounts, and justifications. It includes sections for listing individual items requiring funding, their associated costs, and the reasoning behind each expense. The document also includes administrative sections for team contact information, with spaces for an FC Consultant and FC Supervisor's phone numbers, and areas for official approvals including the DCS Specialist's signature and approval date and time. While the form is currently blank, it is clearly intended to provide a standardized process for quickly authorizing and documenting emergency financial support.
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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 .