ࡱ> g :bjbj٘ *~7RmB B B B B V V V 8eQlV 4S %%%%{&N'u(X1 QQQQQQ$&UWQ)B ({&{&((QB B %%R]/]/]/(FB %B %1]/(1]/]/]/%$]M)]/0S04S]/X) X]/XB ]/((]/(((((QQ,@(((4S((((X((((((((( : ASSESSMENT FOR DETERMINATION OF CARE FOR CHILDREN IN FOSTER CARE (Age Thirteen Years and Over) Michigan Department of Human ServicesCase NameLog Number FORMTEXT        FORMTEXT       FORMTEXT      Case NumberCountyDistrictSectionUnitLast Assessment Score/Level/End Date FORMTEXT       FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT    FORMTEXT      Date of BirthBegin DateEnd Date FORMTEXT       FORMTEXT       FORMTEXT      Foster Home Name FORMTEXT      Legal StatusPermanency Goal FORMTEXT       FORMTEXT       INSTRUCTIONS: Check the statement that most accurately describes the foster parent activity. Enter the number in the box marked  Score. Do not check the same activity more than once. Specify the foster parent activity for each item scored. A foster care provider or supervising agency/DHS staff may initiate a request for review of a DOC at any time. The request must be done in writing. Action must be taken within 30 days of the receipt of the request. If the foster care provider or the agency disagrees with the level of care determination, an administrative review process may be initiated within 30 calendar days of the decision. See FOM 903-3. When a DOC supplement is due to a physical or mental disability, screen the youth for SSI eligibility: see FOM 902-10 SSI Benefits Determination. The term foster parent as used on this form includes licensed foster parents and relatives of state wards eligible for state ward board and care payments. NOTE: If the child has a documented medical condition which threatens health, life or independent functioning, please do not complete this form. Complete the DHS-1945. 1.Behavior Management: All foster parents are expected to manage behavior. This section evaluates foster parent involvement above and beyond what would normally be expected of a foster parent to manage age appropriate behaviors. No special involvement provided by the Foster parent. Child actions are age appropriate. FORMCHECKBOX 0Foster parent provides special and extensive involvement in scheduling and monitoring of time and/or activities, and/or crisis management at least weekly. At least 2 hours per week of direct foster parent involvement in scheduling, behavior charting, monitoring, redirecting, supervising and/or managing behaviors. FORMCHECKBOX 20Foster parent provides special and extensive involvement in scheduling and monitoring of time and/or activities, and/or crisis management on a daily basis. At least 1 hour per day of direct foster parent involvement in scheduling, behavior charting, monitoring, redirecting, supervising and/or managing behavior. FORMCHECKBOX 40Foster parent provides special and extensive involvement in scheduling and monitoring of time and/or activities, and/or crisis management on a constant basis. Constant direct foster parent involvement in scheduling, behavior charting, monitoring, redirecting, supervising and/or managing behavior. FORMCHECKBOX 60Foster Parent Activities:SCORE( FORMTEXT       FORMTEXT       2.Mental Health Participation: Therapy/counseling is defined as a clinical or outreach session provided by a master s level or above mental health professional. This does not include case management contacts and/or visits. Foster parent does not participate in the childs mental health services or the child is not in counseling/therapy. FORMCHECKBOX 0Foster parent participates at least monthly in consultation with the therapist/counselor or with the therapeutic process for the child. The foster parent is involved in a (monthly) formal discussion with the therapist by phone or in person, focused on the childs treatment plan, behaviors, progress, and/or implementation of the therapeutic plan. This does not include brief and/or casual conservation with the therapist. FORMCHECKBOX 7Foster parent participates at least twice per month with the therapy sessions or with the therapeutic process for the child. The foster parent is involved in a (at least twice per month) formal discussion with the therapist by phone or in person, focused on the childs treatment plan, behaviors, progress, and/or implementation of the therapeutic plan. This does not include brief and/or casual conversation with the therapist. FORMCHECKBOX 14Foster parent participates at least weekly with the therapy sessions or with the therapeutic process for the child. The foster parent is involved in a (at least weekly) formal discussion with the therapist by phone or in person, focused on the childs treatment plan, behaviors, progress, and/or implementation of the therapeutic plan. This does not include brief and/or casual conversation with the therapist. FORMCHECKBOX 21Foster Parent Activities:SCORE( FORMTEXT       FORMTEXT      3.Education Participation: This category is for school aged children and/or those children who are part of a child development program due to a certified disability or diagnosed condition. An educational need must be identified which requires foster parent participation in regular appointment with the school, specialized training in specific techniques, and follow-through on the in-home portion of a treatment plan, Individualized Education Plan or equivalent. Routine age appropriate assistance and supervision of homework does not qualify. Foster parent participation not required at home or school beyond regular age appropriate expected education intervention. FORMCHECKBOX 0Foster parent participation requiring collaboration with the school personnel and at least 1/2 hour of daily intervention beyond age appropriate expectation. FORMCHECKBOX 8Foster parent participation requiring collaboration with the school personnel and more than 1/2 hour to 2 hours of daily intervention at home, beyond age appropriate expectations. FORMCHECKBOX 16Foster parent participation requiring collaboration with the school personnel and more than 2 hours of daily intervention at home, beyond age appropriate expectations. FORMCHECKBOX 24Foster Parent Activities:SCORE( FORMTEXT       FORMTEXT      4.Transportation: Routine transportation is not to be included. Routine transportation is defined as school and social activities normally expected for children placed in foster care, and includes sibling visitations, parental visits, routine medical, dental appointments, and age appropriate extracurricular activities. See FOM 722-6 for school transportation resources due to the Fostering Connections Act. Transportation for exceptional medical needs is covered under medical transportation. See BAM-825. No special transportation provided beyond routine child needs. FORMCHECKBOX 0Foster parent is required to transport child two to seven times a month for therapeutic or medical treatment, emotional or social counseling, as outlined in the treatment plan. FORMCHECKBOX 10Foster parent is required to transport child eight to twelve times a month for therapeutic or medical treatment, emotional or social counseling, as outlined in the treatment plan. FORMCHECKBOX 20Foster parent is required to transport child thirteen or more times a month for therapeutic or medical treatment, emotional or social counseling, as outlined in the treatment plan. FORMCHECKBOX 30Foster Parent Activities:SCORE( FORMTEXT       FORMTEXT       5.Personal Care: This section is generally not applicable to children under the age of 4. The child must have a physical or mental condition that limits his/her ability to perform age appropriate personal care tasks. Foster parent assistance not required beyond age appropriate need. The child has the physical and/or mental capabilities to perform personal care tasks. FORMCHECKBOX 0Foster parent provides in home assistance 4 to 10 hours per week because of impairments requiring assistance beyond age appropriate needs with feeding, bathing, grooming, physical and/or occupational therapy. The child has a medically documented physical and/or mental impairment that renders him/her incapable of performing the described tasks without 4-10 hours of foster parent assistance per week. FORMCHECKBOX 18Foster parent provides in home assistance 10 to 20 hours per week because of impairments requiring assistance beyond age appropriate needs with feeding, bathing, grooming, physical and/or occupational therapy. The child has a medically documented physical and/or mental impairment that renders him/her incapable of performing the described tasks without 10-20 hours of foster parent assistance per week. FORMCHECKBOX 36Foster parent provides in home assistance over 20 hours per week because of impairments requiring assistance beyond age appropriate needs with feeding, bathing, grooming, physical and/or occupational therapy. The child has a medically documented physical and/or mental impairment that renders him/her incapable of performing the described tasks without over 20 hours of foster parent assistance per week. FORMCHECKBOX 54Foster Parent Activities:SCORE( FORMTEXT       FORMTEXT      6.Medical Items/Diet: Lice treatment products, not prescribed by a physician, do not qualify. Receipts are required for medical items. Receipts are required and the expenses must be prorated over a 6 months period to qualify. Not required. The child requires no special medical items or special diet. FORMCHECKBOX 0Foster parent provides over the counter medical supplies not covered by Medicaid, such as medically required medications, bandages, and/or special diet requirements, of at least $20 per week. FORMCHECKBOX 8Foster parent provides over the counter medical supplies not covered by Medicaid, such as medically required medications, bandages, and/or special diet requirements, between $21 and $35 per week. FORMCHECKBOX 16Foster parent provides over the counter medical supplies not covered by Medicaid, such as medically required medications, bandages, and/or special diet requirements, in excess of $35 per week. FORMCHECKBOX 24Foster Parent Activities:SCORE( FORMTEXT       FORMTEXT      7. Add scores from Question 1-6 TOTALSCORE  FORMTEXT       8.This section is required for Level IV requests.8A.Document the current DOC status, and why/how the scenario has changed, or necessitates an increase in level. FORMTEXT      8B.Document the extraordinary behaviors and needs of the child. FORMTEXT      8C.Explain how the reimbursement amount was determined. Document the extraordinary care, activities and supervision required by the foster parent. 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FORMTEXT      8D.List/describe any other services and payments being provided for the child s care (i.e. assisted care, nursing services, day care, counseling therapy etc.). FORMTEXT      8E.Attach the current DHS-626, pending 626 for level IV DOC (with the county directors signature) and, ISP/USP/PWSP. Attach any additional supporting documents: (i.e. medical reports/records, therapy reports, IEPs, etc.). Please ensure that all required signatures and dates have been obtained on all documents, foster parents, services specialist, services supervisor and county director. Once completed submit packet to: Field Operations Administration 235 S. Grand Ave., Suite 415 P.O. Box 30037 Lansing, MI 48909  Case NameLog Number REF FirstName2    REF LastName2   REF LogNo  9. EMBED PBrush  Level I Score 11-60 ($6.00)Age Appropriate Rate9A $ FORMTEXT       Level II Score 61-100 ($11.00)(Determination of Care(if appropriate)9B $ FORMTEXT       Level III Score 101-170 ($16.00) Level IV negotiated rateTOTAL FOSTER PARENT RATE (8A + 8B):9C $ FORMTEXT      Begin DateEnd DateADMINISTRATIVE RATE:9D $ FORMTEXT       REF BeginDate \h   REF EndDate \h  (if appropriate)Approval not to exceed 6 months.TOTAL PER DIEM RATE (9C + 9D): $ FORMTEXT       FORMCHECKBOX Due to the foster parents extensive activities a Level IV exception is being requested.Check all appropriate boxes below: FORMCHECKBOX Initial FORMCHECKBOX Renewal FORMCHECKBOX Approved FORMCHECKBOX Escalation FORMCHECKBOX Descalation FORMCHECKBOX DeniedIf denied, reason why: FORMTEXT DFHJr -$Ifgdn $Ifgd{^ekdP$$If94F +D(+    4 9af4ytn rtv~ $IfgduIN $IfgduINbkdQ$$If9 F +D(+    4 9ayt -$Ifgdn $IfgduINekdIR$$If94F +D(+    4 9af4ytn  $IfgduIN $IfgduINbkdSS$$If9 F +D(+    4 9ayt W_`nouv "$8<>`blnpr HLȻȻȴȻȴЬНЏЬ h15jVhSUhhPUj)6 hSUhhPUVjhSUhhPUhhSUhhP5 hhPhhPh~PmHnHuhjhU hSUhhPhhPh1 hSUhuIN huINhuINh@B-$If$If $$Ifa$-$d$Ifa$gd { $IfBDF)#$Ifkd[$$If94 jHl H%+G`\ `pzF_$$$$4 9af4ytXFHJlnp|-$If$If $$Ifa$ { $If)#$Ifkdq\$$If94 jHl H%+G \ pzF_$$$$4 9af4ytX-$If$If $$Ifa$ { $If<6)  Y$If$Ifkdk]$$If94ִjHl H%+G`\  $ zF_    4 9af4ytX -$If$If $$Ifa$ D<3! { $Ifgd.9 $Ifgd Ykde^$$If94ִjHl H%+G \  $ zF_    4 9af4ytX"$BFHJPTVXZ\df&(TVXbdxz|ճ~jhn Ujh15UmHnHujMchhPh15Ujh15Uh1#jhSUh15UmHnHujahSUh15UjhSUh15U h5 h.95hSUh15 h15 hSUh10DFHJLNP -$Ifgd Y $Ifgd Y $$Ifa$gd YPRTV<3# Y$Ifgd Y $Ifgd YkdQ_$$If94ִjHl H%+G`\ $ zF_    4 9af4ytXVXZ\^`b -$Ifgd Y $Ifgd Y $$Ifa$gd Ybdfh<6)  Y$If$Ifkd8`$$If94ִjHl H%+G \ $ zF_    4 9af4ytXh-$If$If $$Ifa$<6)  Y$If$Ifkda$$If94ִ l H%+GzF_    4 9af4ytX-$If$If $$Ifa$(<6-- $IfgdhP$Ifkdkb$$If94ִ l H%+GzF_    4 9af4ytX(RTVb-$If$If $$Ifa$ $$Ifa$gd8e$Ifkdc$$If94 l H%+G zF_$$$$4 9af4pytX "*,nZ\ټƷƷƭف}r}ng hSUhXhXjhh1Uh1jh1Ujh15UmHnHujfhhPh15U h15jh15U h5hh15\hSUh15jYehn U hSUh1h~PmHnHujhn Ujdhn Uhn ( "$&(-$If$If $$Ifa$ $$Ifa$gd8e -$Ifgd8e -$IfgdhP(*,$Ifkde$$If94 l H%+G zF_$$$$4 9af4pytX,n[d[ $Ifgd8ekdag$$If94rBH%*+G4 4 9af4yt-$If $Ifgd[\PG;G 0$$Ifa$gd+ -$Ifgd+?kd-i$$If94 ++4 9af4ytX 0$IfgdXekdh$$If94 F+G(    4 9af4ytX #$%&'>?@JK}jnhvA~UhvA~jhvA~U hSUh+h+jlhXUj'lhXUjkhXU hSUhXhcj}jhXUj jhXU h+hXjihXUhXjhXU1?6 -$Ifgd5kdj$$If94PֈjA+G\ m1 9f 4 9af4ytX 0$$Ifa$gdE -$IfgdE 0$$Ifa$gd+ $%6kdm$$If94PֈjA+G\ m1 9f 4 9af4ytX 0$$Ifa$gdE -$IfgdE -$Ifgd5 0$$Ifa$gd5%&'>?2vm -$Ifgd+?kd9n$$If94 ++4 9af4ytX?kdm$$If94 ++4 9af4ytX 0$Ifgd+     SIGNATURES:Direct Service Worker SignatureDateFoster Parent SignatureDate FORMTEXT       FORMTEXT      Direct Service Supervisor SignatureDate FORMTEXT      DHS Monitor SignatureDateDHS County Director Signature (Required for Level III & IV)Date FORMTEXT       FORMTEXT      DHS Monitor Supervisor SignatureDateField Operations Director or Designee Signature (Required for Level IV)Date FORMTEXT      Department of Human Services (DHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or expression, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you are invited to make your needs known to a DHS office in your area.AUTHORITY: PA 280 of 1939 COMPLETION: Is required by Policy CONSEQUENCE: Correct reimbursement may not be received by the foster parent.     DHS-470-A (Rev. 8-11) Previous edition obsolete. MS Word  PAGE 5 K2 2 222&222222222222233`3b3v3x3z333333<4J4L4`4b4d4n4p4t4ܾ̭ܟܑ̭̭܂vh̭juhSUh+UhvA~@OJQJaJhSUh+@OJQJaJjshSUh+Uj]qhSUh+U jhSUh+UmHnHujphSUh+UjhSUh+U hp5 hSUh+h+jhvA~UmHnHuUjhvA~U(22(2*2j2t222tnnnn$If?kdo$$If94++4 9af4ytX 0$Ifgdp?kdo$$If94++4 9af4yt222223~~~~-x$Ifxkdo$$If94\6#&+o~o4 9af4ytX33N3X3Z3\3$Ifxkdr$$If94 \6#&+o~o4 9af4ytX\3^3`3333~~~~-x$Ifxkdr$$If94\6#&+o~o4 9af4ytX3333<4F4w $IfgdvA~$IfxkdIt$$If94 \6#&+o~o4 9af4ytXF4H4J4r4t44~~~~-x$Ifxkdu$$If94\6#&+o~o4 9af4ytXt4v4444444 555$5&545H5J5^5`5b5d5r5v5555555555555598:::<:>:B:D:H:J:N:P:T:Z:¾¾{h+]h@CJaJhbjhbU hSUhYhB:h+^JaJjxhSUh+UhSUh+5hhph4hvA~h+ jhSUh+UmHnHuj{vhSUh+U hSUh+jhSUh+U/4444z55w $Ifgdp$Ifxkd5w$$If94 \6#&+o~o4 9af4ytX555555~~~~-x$Ifxkdw$$If94\6#&+o~`o4 9af4ytX5555 9V9}=4} $$Ifa$?kd-z$$If94p++4 9af4ytX d$Ifxkdly$$If94\6#&+o~ o4 9af4ytpV998:::<:@:B:F:H:L:N:R:T::::: $ d`gd_y*Pkdz$$If940+4 9af4ytX d$IfZ:t:v:::::::::::```&`(`*`>`@`B`L`N`P`R`f`h`v`x`z```````߸yncj~}hzUj|hzUjhzUmHnHuj{hzUj#{hzUhzjhzU hSUhYhbh@h+]h@CJaJh?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root Entry  F$]MData ˙WordDocument*~ObjectPool $]M$]M_919677435 F$]M$]MOle PIC LCompObjM  !"#%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOQRSTUVWXYZ[\]^`abcdefghijklmopqrstuvwxyz{|~Lr FPaintbrush PicturePBrushPBrushBMv(pUUUUObjInfo Ole10Native Ole10ItemName 1Table 0 0 15 14Oh+'0( 8D d p | LDHS-0470A - Assessment of Difficulty of Care forI7N/jE,- NIENDB`$$If!vh#vG#v^#v#v:V 94+5G5^55/ / 44 9f4ytXjD $$If!v h#vG#v\ #v#vp#v#v#vz#vF#v _:V 94++5G5\ 55p555z5F5 _/ / /  44 9f4ytX$$If!v h#vG#v\ #v#vp#v#v#vz#vF#v _:V 94+5G5\ 55p555z5F5 _/ / /  44 9f4ytX$$If!v h#vG#v\ #v#vp#v#v#vz#vF#v _:V 94++5G5\ 55p555z5F5 _/ /  44 9f4ytXjD $$If!v h#vG#v\ #v#vp#v#v#vz#vF#v _:V 94++5G5\ 55p555z5F5 _/ / /  44 9f4ytX$$If!vh#vG#v\ #v#v$ #v#vz#vF#v_:V 94++5G5\ 55$ 55z5F5_/ / / / 44 9f4ytX$$If!vh#vG#v\ #v#v$ #v#vz#vF#v_:V 94++5G5\ 55$ 55z5F5_/ / / 44 9f4ytX$$If!vh#vG#v\ #v#v$ #v#vz#vF#v_:V 94+5G5\ 55$ 55z5F5_/ / / 44 9f4ytX$$If!vh#vG#v\ #v#v$ #v#vz#vF#v_:V 94+5G5\ 55$ 55z5F5_/ / / 44 9f4ytXjD $$If!vh#vG#v#v#v#v#vz#vF#v_:V 945G55555z5F5_/ / / 44 9f4ytX$$If!vh#vG#v#v#v#v#vz#vF#v_:V 945G55555z5F5_/ / / 44 9f4ytXjD +$$If!v h#vG#v#v #v#v#vz#vF#v _:V 945G55 555z5F5 _/  / / / / /  44 9f4pytXuDyK  BeginDateqDyK EndDate+$$If!v h#vG#v#v #v#v#vz#vF#v _:V 945G55 555z5F5 _/ / / / / /  44 9f4pytXjD $$If!vh#vG#v4#v #v#v:V 945G545 55/ / / 44 9f4yttDeCheck2$$If!vh#vG#v#v(:V 94 5G55(/ /  / 44 9f4ytXf$$If!vh#v+:V 94 5+/  44 9f4ytXtDeCheck3tDeCheck3tDeCheck3$$If!vh#vG#v\ #vm#v1 #v9#vf :V 94P,5G5\ 5m51 595f / / 44 9f4ytXtDeCheck3tDeCheck3tDeCheck3$$If!vh#vG#v\ #vm#v1 #v9#vf :V 94P,5G5\ 5m51 595f / / 44 9f4ytXf$$If!vh#v+:V 94 5+/  44 9f4ytXf$$If!vh#v+:V 94 5+/  44 9f4ytXvDdText12f$$If!vh#v+:V 945+/ 44 9f4ytf$$If!vh#v+:V 945+/ 44 9f4ytX$$If!vh#vo#v~#vo#v:V 945o5~5o5/ / / /  44 9f4ytXD date1#Enter the Date (Example: 4/12/1997)D date1#Enter the Date (Example: 4/12/1997)$$If!vh#vo#v~#vo#v:V 94 5o5~5o5/ / / / 44 9f4ytX$$If!vh#vo#v~#vo#v:V 945o5~5o5/ / / /  44 9f4ytXD date1#Enter the Date (Example: 4/12/1997)$$If!vh#vo#v~#vo#v:V 94 5o5~5o5/ / / /  44 9f4ytX$$If!vh#vo#v~#vo#v:V 945o5~5o5/ / / /  44 9f4ytXD date1#Enter the Date (Example: 4/12/1997)D date1#Enter the Date (Example: 4/12/1997)$$If!vh#vo#v~#vo#v:V 94 5o5~5o5/ / / / 44 9f4ytX$$If!vh#vo#v~#vo#v:V 94+5o5~5o5/ / / /  44 9f4ytXD date1#Enter the Date (Example: 4/12/1997)$$If!vh#vo#v~#vo#v:V 94+5o5~5o5/ / / /  44 9f4ytpX$$If!vh#v+:V 94p5+44 9f4ytX$$If!vh#v#v:V 9455/ / / / 44 9f4ytXDAddress1 UppercasedEnter the Addressee's mail address (street address, PO Box, etc., where the mail will be delivered). ClientCitySummaryInformation( DocumentSummaryInformation8pMsoDataStore$]M_$]MERLCU04GCQ==2$]M_$]M Children in Foster Carecomp 0470-A.dotbushd227Microsoft Office Word@ފH?@>MG@@8]M6.՜.+,0@ hp  !State of Michiganc6 IDHS-0470A - Assessment of Difficulty of Care for Children in Foster Care Title ]0* pHdTemplateProjectQH@  = | j: J< 9stdole>stdoleP h%^*\G{00020430-C 0046}#2.0#0#C:\WINDOWS\system32\e2.tlb#OLE Automation0MSForms>SFFrms3dir$ Unit PCoZip _Date1 nED452EE1-E08F-101A-8-02608C4D0BB4EFM20.DLL#Microsoft : ^ Ob Library/;D~1u00}#0#k0 B93EC931- 5114-95-8D97-22894C6A06CF6DOCUME~1\bushd2\LOCALS\VBE\Tp.exd;@!.E .`M AOfficODf@ic 12DF8D04C-5BFAgB-BDE5IAA421gram Files\Comm onhShared\OFFIChE145Op& 8.0p@%ӈ2*»ThisDocumentG *T@iDcuen@ 2 HB1%BE,!*""+SuperPhoneNumberG `p@-rP o`eNbr2r" *!iGranteeFirstNamecG` a&e`Fi!Na)cmc}alWorker@ExtensG1WSHv2sB4=Q [ _r0L3A b=фGG=tF= V _ ;!+.2@)u_- 8uofGb=m@!vRwD C / qpu0lastn 2#lsun2$#  0FirsVtt0FQrAtHt0#?!0nddressc sddBts`!#?!)1ma sť"%r?!+,_L@0@si2qa-pDistrictG D@APrc@Qaecma/pA#?1cA>>1_aecWma!l,SectionG`~i~n]2Q#_OtherIDS OhrI~DTS _?%_CoSt\atp3Sa0eTS __'_Prr@;Ar2=c%CooW_y@9_" ]D"\sS _\4;\$lGN @$2K=`Hidde+H:S? 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GE{ UpdateFieldGpfSOed0253z\c* *xMEH &8 " 0Unit, (B@*oXPiAttribute VB_Name = "Unit" Public Sub MAIN() WordBasic.WW7_EditGoTo Destinat ion:=Endv \c* *     +" !#*$%&'(),4>-./01235=6789:;<?FO@ABCDEGNHIJKLMPn{QRSTlVWXYZ[\]^_`abcdefghijkmovpqrstuwxyz|}~xMEH &8 " 0cozip, (B@*oXPoAttribute VB_Name = "CoZip" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cDozEndx \c*7*xMEH &8 " 0date1, (B@*oXPlAttribute VB_Name = "Date1" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="dEndx \c*5*xFaxAC }CareOfCoCityHiddenqMEH &8 " 0FaxAC, (B@*oXPjAttribute VB_Name = "FaxAC" Public Sub MAIN() WordBasic.WW7_EditGoTo Destina@tion:=Endx \c*3*xMEH &8 " 0careof, (B@*oXPqAttribute VB_Name = "CareOf" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="coEndz \c*1*xMEH &8 " 0cocity, (B@*oXPpAttribute VB_Name = "CoCity" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cocEndz *?*xME &@p(Makes the selection hidden text (toggle)pTemplateProject.Hidden.MAINh "10 0 pt0 pt0bArial (B@ophxAttribute VB_Name = "Hidden" Public Sub MAIN(X) D.nDescription|Makes the selec,h text (toggle)Pro cDataWInvoke_FuncWTemplaTte"jV..JWordBasic.FormatFont Points:="10", Underline:=0, Color@:=9, SkeThrough SuperjFb<:=1mallCap1)ASpacinBg=0 pt>PosiKernMinTabd ArialBoldIIta End WorkerAddRowsqCorrectCoState!\c*=*xMEH &8 " 0worker, (B@*oXPlAttribute VB_Name = "Worker" Public Sub MAIN() tdBasic.WW7_EditGoTo Destination:="wEndz {*;*xME &@p+Adds row to table FOLLOWING cursor location TemplateProject.AddRows.MAINh "0@ (B@ (B@oH@Attribute VB_Name = "AddRows" Public Sub MAIN() D.pDescription~s row to table FOLLOWING cursor loca\NProcDataZInvoke_FuncZTemplateA"ject..KWordBasic.LineDown 1 TInserBt Numt:D="Ends t{s*9*xME` & @  " V*h    ]@Q This serves as a replacement to the spell checker within a protected documentCheck spelling now? (%'  (B@J5 (B@; (B@? "Rl (B@Pko0Attribute VB_Name = "Correct" Public Sub MAIN() Dim ans Rem This se@rves a replacement to the spell checker within @a proted docu3 ZWordBasic.MsgBox("C?King now ?", 3If4-1en  QATools4UnoDi %St`artOf"S7d>0Pg NoReset:=1, Type:=2 End If       !"#$&'()*+,-./012356789:;<=>?@ABDEFGHIJKLMNOPQSTUVWXYZ[\]^_`bcdefghijklmnoqrstuvwxyz{|}~\c*'*xMEH &8 "(8costate, (B@*oPHqAttribute VB_Name = "CoState" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cosEnd| \c*%*OtherIDSection "Address1%District34xMEH &8 "(8otherid, (B@*oPHsAttribute VB_Name = "OtherID" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=$"oidEnd| \c*#*xMEH &8 "(8Section, (B@*oPHjAttribute VB_Name = "Section" Public Sub MAIN() WordBasic.WW7_EditGoTo Desti$nar:=End| \c*!*xMEH &8 "(8Address1, (B@*oPHnAttribute VB_Name = "Address1" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:"= End~ \c*/*xMEH &8 "(8district, (B@*oPHoAttribute VB_Name = "Disct" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=""dEnd~ \c*-*xMELastNameCClientZip$&RCoAddressaFirstName%)pH &8 "(8lastname, (B@*oPHsAttribute VB_Name = "LastX" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="lnEnd~ \c*+*xMEH &8 "(8 clientZip, (B@*oPHqAttribute VB_Name = "ClientZip" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cEnd \c*)*xMEH &8 "(8 coaddress, (B@*oPHsAttribute VB_Name = "CoAddress" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination@:="coaEnd \c**xMEH &8 "(8 firstname, (B@*oPHtAttribute VB_Name = "First`" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="fnEnd \c**lastname2RemoveRow(*WorkerFaxCaseNumber'/xMEH &8 "(8 LastName2, (B@*oPHtAttribute VB_Name = "lastnX2" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="LEnd \ck**xMEH &8 "   (8Xh (B@J (B@r (B@t Rl (B@Po Attribute VB_Name = "RemoveRow" Public Sub MAIN() WordBasic.ToolsUnprotectDocument BableS\el<2Dt oYP W NoReset:=1, Type:=2 End \c**xMEH &8 "(8 WorkerFax, (B@*oPHmAttribute VB_Name = "WorkerFax" Public Sub MA@IN() dBasic.WW7_EditGoTo Destination:= End \c**xMEH &8 "(8 casenumber, (B@*oPHuAttribute VB_Name = "CaseNumber" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cnEnd \c**xClientCityCoAreaCode,.CountyNameGranteeZip-1MEH &8 "(8 clientcity, (B@*oPHuAttribute VB_Name = "ClientCity" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="ccEnd \c**xMEH &8 "(8 coareacode, (B@*p oPHxAttribute VB_Name = "CoAreaCode" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="coa"cEnd \c**xMEH &8 "(8 countyname, (B@*oPHuAttribute VB_Name = "Countyh" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=4"cnEnd \c**xMEH &8 "(8 GranteeZip, (B@*oPHpAttribute VB_Name = "GranteeZip" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:= End \c**xMEH &WorkerNameClientState02CoExtensionGranteeCity+;&      !"#$%'()*+,-./012346789:;<=>?@ABDEFGHIJKLMNOPQSTUVWXYZ[\]^_`bcdefghijklmnoqrstuvwxyz{|}~8 "(8 workername, (B@*oPHtAttribute VB_Name = "Workerh" Public Sub MAIN() dBasic.WW7_EditGoTo Destination:="wnEnd \c**xMEH &8 "(8 clientstate, (B@*oPHvAttribute VB_Name = "ClientState" Public Sub MAIN() WordBasic.WW7_EditGoTo Destinati@on:="csEnd \c**xMEH &8 "(8 coextension, (B@*oPHtAttribute VB_Name = "CoExtension" Public Sub MAIN() WordBasic.WW7_EditGoTo Destinatr@:="coeEnd \c**xMEH &8 "(8 GranteeCity, (B@*oPHqAttribute VB_Name = "GranteeCity" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:= End \c*xUpdateField5]WorkerPhone46CcountynumberRGranteeState59aMEH 8"( !B@o`XXAttribute VB_Name = "UpdateField" Sub D () ActiveDocu ment.Zs.P End p \c**xMEH &8 "(8 workerphone, (B@* oPHuAttribute VB_Name = "WorkerPhone" Public Sub MAIN() dBasic.WW7_EditGoTo DestinationP:="wpEnd \c*ExMEH &8 "(8 Countynumber, (B@*oPHtAttribute VB_Name = "countynumber" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="C End \c**xMEH &8 "(8 GranteeState, (B@*oPHrAttribute VB_Name = "GranteeState" Public Sub MAIN() WordBasic.WW7_EditGoTo Destinat ion:= End NewParagraphp^ThisDocument8:_VBA_PROJECTUT,CoPhoneNumber7?\c**xMEH &8 " (@`px (B@H (B@J $N (B@LRl (B@P (B@ToŰAttribute VB_Name = "NewParagraph" Public Sub MAIN() WordBasic.ScreenUpdating 0 >ToolsUnprotectDo@cument Insert Chr(13[?P = NoReset:=1, Type:=2 QCharRight 1 End **#xME (SLSS<N0{00020906-0000-0000-C000-000000000046}8(%HxAttribute VB_Name = "ThisDocument" Bas0{00020P906-0C$0046} |GlobalSpacFalse dCreatablPredeclaIdTru BExposeTemplateDerivBustomizD2\c**xMEa  *\G{000204EF-0000-0000-C000-000000000046}#4.1#9#C:\PROGRA~1\COMMON~1\MICROS~1\VBA\VBA7\VBE7.DLL#Visual Basic For Applications*\G{00020905-0000-0000-C000-000000000046}#8.5#0#C:\Program Files\Microsoft Office\Office14\MSWORD.OLB#Microsoft Word 14.0 Object Library*\G{00020430-0000-0000-C000-000000000046}#2.0#0#C:\WINDOWS\system32\stdole2.tlb#OLE Automation*\G{0D452EE1-E08F-101A-852E-02608C4D0BB4}#2.0#0#C:\WINDOWS\system32\FM20.DLL#Microsoft Forms 2.0 Object Library*\G{093EC931-5114-4525-8D97-22894C6A06CF}#2.0#0#C:\DOCUME~1\bushd2\LOCALS~1\Temp\VBE\MSForms.exd#Microsoft Forms 2.0 Object Library.E .`M &*\G{2DF8D04C-5BFA-101B-BDE5-00AA0044DE52}#2.5#0#C:\Program Files\Common Files\Microsoft Shared\OFFICE14\MSO.DLL#Microsoft Office 8.0 Object Library2 j: )*'(-.+,1/0"# !&$%*2ThisDocument054f228f4d!ThisDocument*% SuperPhoneNumber064f228f4d$ SuperPhoneNumber*% GranteeFirstName074f228f4d. GranteeFirstName*0%WorkerExtension084f228f4d0WorkerExtension*H%GranteeLastName094f228f4d2GranteeLastName*`%GranteeClientID0:4f228f4d4GranteeClientID*x%GranteeAddress10;4f228f4d6GranteeAddress1*%WorkerAreaCode0<4f228f4d8WorkerAreaCode*SupervisorName0=4f228f4d:SupervisorName*SuperExtention0>4f228f4d<SuperExtention*SuperAreaCode0?4f228f4d>SuperAreaCode*GranteeCareof0@4f228f4d@GranteeCareof*CoSuppaddress0A4f228f4dBCoSuppaddress* CoPhoneNumber0B4f228f4dDCoPhoneNumber*8NewParagraph0C4f228f4dFNewParagraph*PGranteeState0D4f228f4dVGranteeState*hUnit0E4f228f4dXUnit *WorkerPhone0F4f228f4dZWorkerPhone*GranteeCity0G4f228f4d\GranteeCity*CoExtension0H4f228f4d^CoExtension*ClientState0I4f228f4d`ClientState*WorkerName0J4f228f4dbWorkerName*GranteeZip0K4f228f4ddGranteeZip*CountyName0L4f228f4dfCountyName*(CoAreaCode0M4f228f4dhCoAreaCode*@ClientCity0N4f228f4djClientCity*XCaseNumber0O4f228f4dlCaseNumber*pWorkerFax0P4f228f4dnWorkerFax*RemoveRow0Q4f228f4dpRemoveRow*qlastname20R4f228f4dvlastname2*FirstName0S4f228f4dxFirstName*CoAddress0T4f228f4dzCoAddress)*ClientZip0U4f228f4d|ClientZip+*LastName0V4f228f4d~LastName-*District0W4f228f4dDistrict/*0Address10X4f228f4dAddress1!*HSection0Y4f228f4dSection#*`OtherID0Z4f228f4dOtherID%*xCoState0[4f228f4dCoState'*Correct0]4f228f4dCorrect9*yAddRows0^4f228f4dAddRows;* Worker0_4f228f4d Worker=* Hidden0`4f228f4d Hidden?* CoCity0a4f228f4d CoCity1* CareOf0b4f228f4d CareOf3*  FaxAC0c4f228f4d FaxAC5*8 Date10d4f228f4d Date17*P CoZip0e4f228f4d CoZip *hcountynumber0f4f228f4dcountynumberEUpdateField0g4f228f4dUpdateFieldxhXHHP`8( `0h8pGRCc#gW @Z2}rKS2t=&dMvMoCqDSPܫ6Mi@ERc8!+NQx<$ϰ3cK2@uQ,BQoB̠dT 5 F6%QUM\SI:wjJGx}fS+_?KEæ3xMot$T:2GixBh@.Gz.J Fgn|o6M +W0K C]Z:ޮ0Gڮh֗z8ᾮCr}1w!AC3H *fʧFї%{ H6]OmފN̋2Kk$:-t'Om/qK@ :K4?RC*@IP#Ddi4rBR<(=]x+ډZ#Hmծl[q6B/ſP&H0A†r:R2:RvF5rBC>xFҘ%m$Jx=,oT?rCyF[K!}ovE$xO$;QSgwGoH7zHjgL4WordkVBAWin16~Win32Win64xMacVBA6#VBA7#TemplateProjectEstdole`MSFormsCOfficeu ThisDocument< _EvaluateSuperPhoneNumber\MAIN, WordBasic WW7_EditGoTod DestinationлGranteeFirstNameEWorkerExtensionGranteeLastName.GranteeClientIDGranteeAddress1WorkerAreaCodeSupervisorNameSuperExtention SuperAreaCodeq GranteeCareof CoSuppaddress^  CoPhoneNumberx NewParagraphqScreenUpdating! ToolsUnprotectDocument(InsertrChrK~ToolsProtectDocument-0NoResetg CharRightP GranteeStateMUnit WorkerPhone GranteeCity@ CoExtensionK ClientState WorkerNameJ GranteeZip  CountyName CoAreaCode ClientCitym CaseNumberA WorkerFaxv RemoveRow0^TableSelectRowTableDeleteRowA lastname2sL FirstName CoAddress ClientZipLastNameDistrict}-Address1OSectionGOtherIDCoState1Correct'ansxtMsgBoxRStartOfDocument ToolsSpellingAddRowsLineDownxTableInsertRowQNumRowsWorker8Hidden] FormatFont&Points UnderlineColor2F StrikeThrough" Superscript SubscriptV SmallCaps~cAllCapss_SpacingSPositionKerningB KerningMin1FontUBoldItalic!CoCityr7CareOfƻFaxACjDate11CoZip0 countynumberyx UpdateFieldKActiveDocument\Fields7UpdateDocumentj+o,-./01e !%0/21738597:9;;<= =? >A ?C @E AGBWCYK[L]M_NaOcPeQgRiSkTmUoVqWwXy[{\} ]!^"_#`$a%b&c'd(j)j*npH &8 " (8 coPhonenumber, (B@*oPHyAttribute VB_Name = "CoPhoneNumber" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cEnEnd \c**xMEH &CoSuppaddressGranteeCareof<>SuperAreaCodeSuperExtention=C8 " (8 cosuppaddress, (B@*oPHxAttribute VB_Name = "CoSuppaddress" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cDos End \c**xMEH &8 " (8 Granteecareof, (B@*oPHvAttribute VB_Name = "GranteeCareof" Public Sub MAIN() WordBasic.WW7_EditGoTo Destina@tion:=cEnd \c**xMEH &8 " (8 superareacode, (B@*oPH}Attribute VB_Name = "SuperAreaCode" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="sacEnd \c**xMEH &8 " (8superextension, (B@*oPH|Attribute VB_Name = "SuperExtention" Public Sub MAIN() WordBasic.WW7_EditGoTo DestinBar:="sesEnd \c**xSupervisorNameWorkerAreaCode@BGranteeAddress1 GranteeClientID AE MEH &8 " (8supervisorname, (B@*oPH{Attribute VB_Name = "Supervisor" Public Sub MAIN() WordBasic.WW7_EditGoTo Destinati@on:="snCEnd \c**xMEH &8 " (8workerareacode, (B@*oPH|Attribute VB_Name = "WorkerAreaCode" Public Sub MAIN() dBasic.WW7_EditGoTo Destination:="wacEnd \c**xME     !"#$%&')*+,-./012345689:;<=>?@ABCDEGHIJKLMNOPQRSTVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}H &8 ""0@GranteeAddress1, (B@*oH@uAttribute VB_Name = "GranteeAddress1" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=End \c**xMEH &8 ""0@GranteeClientID, (B@*gyoH@uAttribute VB_Name = "GranteeClientID" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=End \c**xMEH &GranteeLastName WorkerExtension DF(GranteeFirstName"G7SuperPhoneNumber"F8 ""0@granteelastname, (B@*oH@~Attribute VB_Name = "GranteeLast" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="glnEnd \c**xMEH &8 ""0@workerextension, (B@*oH@xAttribute VB_Name = "WorkerExtension" Public Sub MAIN() dBasic.WW7_EditGoTo DestinaBtr:="weEnd \c**xMEH &8 ""0@granteefirstname, (B@*oH@Attribute VB_Name = "GranteeFirstL" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="g5fnEnd \c**xMEH &8 ""0@superphonenumber, (B@*oH@Attribute VB_Name = "SuperPhoneNumber" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="spnEnd ID="{1D284EB6-C119-4004-8788-6E1563577717}" Document=ThisDocument/&H00000000 Module=SuperPhoneNumber Module=GranteeFirstName Module=WorkerExtension Module=GranteeLastName Module=GranteeCPROJECTIU PROJECTwm~CompObjrlientID Module=GranteeAddress1 Module=WorkerAreaCode Module=SupervisorName Module=SuperExtention Module=SuperAreaCode Module=GranteeCareof Module=CoSuppaddress Module=CoPhoneNumber Module=NewParagraph Module=GranteeState Module=WorkerPhone Module=GranteeCity Module=CoExtension Module=ClientState Module=WorkerName Module=GranteeZip Module=CountyName Module=CoAreaCode Module=ClientCity Module=CaseNumber Module=WorkerFax Module=RemoveRow Module=lastname2 Module=FirstName Module=CoAddress Module=ClientZip Module=LastName Module=District Module=Address1 Module=Section Module=OtherID Module=CoState Module=Correct Module=AddRows Module=Worker Module=Hidden Module=CoCity Module=CareOf Module=FaxAC Module=Date1 Module=CoZip Module=Unit Module=countynumber Module=UpdateField Name="TemplateProject" HelpContextID="0" VersionCompatible32="393222000" CMG="7A78F77F7583758375837583" DPB="F4F679F989728A728A72" GC="6E6CE3832787A088A0885F" [Host Extender Info] &H00000001={3832D640-CF90-11CF-8E43-00A0C911005A};VBE;&H00000000 [Workspace] ThisDocument=0, 0, 0, 0, C SuperPhoneNumber=0, 0, 0, 0, C GranteeFirstName=0, 0, 0, 0, C WorkerExtension=0, 0, 0, 0, C GranteeLastName=0, 0, 0, 0, C GranteeClientID=0, 0, 0, 0, C GranteeAddress1=0, 0, 0, 0, C WorkerAreaCode=0, 0, 0, 0, C SupervisorName=0, 0, 0, 0, C SuperExtention=0, 0, 0, 0, C SuperAreaCode=0, 0, 0, 0, C GranteeCareof=0, 0, 0, 0, C CoSuppaddress=0, 0, 0, 0, C CoPhoneNumber=0, 0, 0, 0, C NewParagraph=0, 0, 0, 0, C GranteeState=0, 0, 0, 0, C WorkerPhone=0, 0, 0, 0, C GranteeCity=0, 0, 0, 0, C CoExtension=0, 0, 0, 0, C ClientState=0, 0, 0, 0, C WorkerName=0, 0, 0, 0, C GranteeZip=0, 0, 0, 0, C CountyName=0, 0, 0, 0, C CoAreaCode=0, 0, 0, 0, C ClientCity=0, 0, 0, 0, C CaseNumber=0, 0, 0, 0, C WorkerFax=0, 0, 0, 0, C RemoveRow=0, 0, 0, 0, C lastname2=0, 0, 0, 0, C FirstName=0, 0, 0, 0, C CoAddress=0, 0, 0, 0, C ClientZip=0, 0, 0, 0, C LastName=0, 0, 0, 0, C District=0, 0, 0, 0, C Address1=0, 0, 0, 0, C Section=0, 0, 0, 0, C OtherID=0, 0, 0, 0, C CoState=0, 0, 0, 0, C Correct=0, 0, 0, 0, C AddRows=0, 0, 0, 0, C Worker=0, 0, 0, 0, C Hidden=0, 0, 0, 0, C CoCity=0, 0, 0, 0, C CareOf=0, 0, 0, 0, C FaxAC=0, 0, 0, 0, C Date1=0, 0, 0, 0, C CoZip=0, 0, 0, 0, C Unit=0, 0, 0, 0, C countynumber=0, 0, 0, 0, C UpdateField=0, 0, 0, 0, C ThisDocumentThisDocumentSuperPhoneNumberSuperPhoneNumberGranteeFirstNameGranteeFirstNameWorkerExtensionWorkerExtensionGranteeLastNameGranteeLastNameGranteeClientIDGranteeClientIDGranteeAddress1GranteeAddress1WorkerAreaCodeWorkerAreaCodeSupervisorNameSupervisorNameSuperExtentionSuperExtentionSuperAreaCodeSuperAreaCodeGranteeCareofGranteeCareofCoSuppaddressCoSuppaddressCoPhoneNumberCoPhoneNumberNewParagraphNewParagraphGranteeStateGranteeStateWorkerPhoneWorkerPhoneGranteeCityGranteeCityCoExtensionCoExtensionClientStateClientStateWorkerNameWorkerNameGranteeZipGranteeZipCountyNameCountyNameCoAreaCodeCoAreaCodeClientCityClientCityCaseNumberCaseNumberWorkerFaxWorkerFaxRemoveRowRemoveRowlastname2lastname2FirstNameFirstNameCoAddressCoAddressClientZipClientZipLastNameLastNameDistrictDistrictAddress1Address1SectionSectionOtherIDOtherIDCoStateCoStateCorrectCorrectAddRowsAddRowsWorkerWorkerHiddenHiddenCoCityCoCityCareOfCareOfFaxACFaxACDate1Date1CoZipCoZipUnitUnitcountynumbercountynumberUpdateFieldUpdateField 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FirstName2 LastName2LogNo CaseNumber CountyNumberDistrictSectionUnit BeginDateEndDate OLE_LINK1Text4Text5Text6Check1Text7Text8Text9Check3Text12date1.BSdu K >u$(224X7 @Qbs^ c Q$(+224X7777 7 7 7 777U7X7 :;`a)*qr**,,--    K ^ c c <<>QVVu$$((((<*O*y,y,,,,,,,v.y.......////// / /!/!/s/s/000122u4444447777 7 7 7 777I7S7X7 :;`a)*qr**,,--    K ^ c c <<>QVVu$$((((<*O*y,y,,,,,,,v.y.......////// / /!/!/s/s/000122u444444777777 7 7 7 777 7!7"7$7U7X7ba6 * 8JbT fQ9@a_y*/143&6.9)=Z/C&DXKs(L75LuINQgNwwP;UYUSVTsX Y+]^[5^{^.V .VV%=.V .VV&<.V .VV';.V .VV(:.V .VV)9.V .VV*8.V .VV+7.V .VV,6.V .VV-5.V .VV.4.V .VV/3.V .VV0.V .V  Spell Check Spell CheckLfQ+LfQ+LfQ+LfQ+LfQ+1(  Spell CheckForms Spell Check2Module1.FormsSpellCheck2gc'TemplateProject.UpdateField.UpdateField%TemplateProject.SuperPhoneNumber.MAIN%TemplateProject.GranteeFirstName.MAIN$TemplateProject.WorkerExtension.MAIN$TemplateProject.GranteeLastName.MAIN$TemplateProject.GranteeClientID.MAIN$TemplateProject.GranteeAddress1.MAIN#TemplateProject.WorkerAreaCode.MAIN#TemplateProject.SupervisorName.MAIN#TemplateProject.SuperExtention.MAIN"TemplateProject.SuperAreaCode.MAIN"TemplateProject.GranteeCareof.MAIN"TemplateProject.CoSuppaddress.MAIN"TemplateProject.CoPhoneNumber.MAIN!TemplateProject.NewParagraph.MAIN!TemplateProject.GranteeState.MAIN!TemplateProject.countynumber.MAIN TemplateProject.WorkerPhone.MAIN TemplateProject.GranteeCity.MAIN TemplateProject.CoExtension.MAIN TemplateProject.ClientState.MAINTemplateProject.WorkerName.MAINTemplateProject.GranteeZip.MAINTemplateProject.CountyName.MAINTemplateProject.CoAreaCode.MAINTemplateProject.ClientCity.MAINTemplateProject.CaseNumber.MAINTemplateProject.WorkerFax.MAINTemplateProject.RemoveRow.MAINTemplateProject.lastname2.MAINTemplateProject.FirstName.MAINTemplateProject.CoAddress.MAINTemplateProject.ClientZip.MAINTemplateProject.LastName.MAINTemplateProject.District.MAINTemplateProject.Address1.MAINTemplateProject.Section.MAINTemplateProject.OtherID.MAINTemplateProject.CoState.MAINTemplateProject.Correct.MAINTemplateProject.AddRows.MAINTemplateProject.Worker.MAINTemplateProject.Hidden.MAINTemplateProject.CoCity.MAINTemplateProject.CareOf.MAINTemplateProject.FaxAC.MAINTemplateProject.Date1.MAINTemplateProject.CoZip.MAINTemplateProject.Unit.MAIN1TEMPLATEPROJECT.UNIT.MAINTEMPLATEPROJECT.COZIP.MAINTEMPLATEPROJECT.DATE1.MAINTEMPLATEPROJECT.FAXAC.MAINTEMPLATEPROJECT.CAREOF.MAINTEMPLATEPROJECT.COCITY.MAINTEMPLATEPROJECT.HIDDEN.MAINTEMPLATEPROJECT.WORKER.MAINTEMPLATEPROJECT.ADDROWS.MAIN TEMPLATEPROJECT.CORRECT.MAIN TEMPLATEPROJECT.COSTATE.MAIN TEMPLATEPROJECT.OTHERID.MAIN TEMPLATEPROJECT.SECTION.MAIN TEMPLATEPROJECT.ADDRESS1.MAINTEMPLATEPROJECT.DISTRICT.MAINTEMPLATEPROJECT.LASTNAME.MAINTEMPLATEPROJECT.CLIENTZIP.MAINTEMPLATEPROJECT.COADDRESS.MAINTEMPLATEPROJECT.FIRSTNAME.MAINTEMPLATEPROJECT.LASTNAME2.MAINTEMPLATEPROJECT.REMOVEROW.MAINTEMPLATEPROJECT.WORKERFAX.MAINTEMPLATEPROJECT.CASENUMBER.MAINTEMPLATEPROJECT.CLIENTCITY.MAINTEMPLATEPROJECT.COAREACODE.MAINTEMPLATEPROJECT.COUNTYNAME.MAINTEMPLATEPROJECT.GRANTEEZIP.MAINTEMPLATEPROJECT.WORKERNAME.MAIN TEMPLATEPROJECT.CLIENTSTATE.MAIN TEMPLATEPROJECT.COEXTENSION.MAIN TEMPLATEPROJECT.GRANTEECITY.MAIN TEMPLATEPROJECT.WORKERPHONE.MAIN !TEMPLATEPROJECT.COUNTYNUMBER.MAIN!!TEMPLATEPROJECT.GRANTEESTATE.MAIN"!TEMPLATEPROJECT.NEWPARAGRAPH.MAIN#"TEMPLATEPROJECT.COPHONENUMBER.MAIN$"TEMPLATEPROJECT.COSUPPADDRESS.MAIN%"TEMPLATEPROJECT.GRANTEECAREOF.MAIN&"TEMPLATEPROJECT.SUPERAREACODE.MAIN'#TEMPLATEPROJECT.SUPEREXTENTION.MAIN(#TEMPLATEPROJECT.SUPERVISORNAME.MAIN)#TEMPLATEPROJECT.WORKERAREACODE.MAIN*$TEMPLATEPROJECT.GRANTEEADDRESS1.MAIN+$TEMPLATEPROJECT.GRANTEECLIENTID.MAIN,$TEMPLATEPROJECT.GRANTEELASTNAME.MAIN-$TEMPLATEPROJECT.WORKEREXTENSION.MAIN.%TEMPLATEPROJECT.GRANTEEFIRSTNAME.MAIN/%TEMPLATEPROJECT.SUPERPHONENUMBER.MAIN0'TEMPLATEPROJECT.UPDATEFIELD.UPDATEFIELD@ j/o/j/j/$A A 4444444$4%()*+,./012W7 @4@ D@&P@,\@4l@:<>@@2UnknownG* Times New Roman5Symbol3. * Arial?= * Courier New9 WebdingsI" Arial (W1)Arial5. *aTahomaA$BCambria Math"hFf6.c6.cr c"2466%a3QHX8s(L*!xx HDHS-0470A - Assessment of Difficulty of Care for Children in Foster Carecompbushd2^A g `ubjbj٘ *~XpXpp}p}p}p}p}}eeQl}~@ t{gggggggdg9p}777gp}p}7777p}p}g77g77XI7$]M77S0777p}777777777gg77777777777777777p 6|:  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT        FORMTEXT        FORMTEXT      FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT        FORMTEXT        FORMTEXT    This is an EXCEL Spreadsheet form To access the FIA-3673, Journal Voucher: 1. Open Microsoft Excel 2. Click File + Open + List Files of Type = Template 3. Locate and Highlight the following file: ASSIST server: G:\Common\Word\Template\3673.XLT SWSS server: D:\Admin\Word\Template\3673.XLT Novell server: P:\Winapps\Winword\Template\3673.XLT 4. Click OK  FORMTEXT      FORMTEXT      :(`P`x````a:a^aaaaa bHbjbbbb( 3?``````````aaaaa(a*a8a:asRsTsbsdsfszs|ssssssssssssssssssssttttt t"t$t8tjhzUjhzUmHnHujPhzUjɐhzUjIhzUjhzUjhzUj]hzUj׍hzUhzjhzUj!hzU1rs<6,+*/.'&%;:$8t:tHtJtLt`tbtptrttttttttttttttttttttttttttuuuuu(u*u,u@uBuPuRuTuhujuxuzu|uujhzUjUhzUjhzUj hzUjIhzUjhzUmHnHujhzUj$hzUjlhzUhzjhzUj’hzU3uuuuuuuuuuuj%hzUhzjhzUmHnHujhzUjIhzU (/ =!"#$% DBureau#Enter your Bureau/Office/Unit name.DCareOf UppercaseUEnter the Addressee's Supplemental Address (Example: Suite or Apartment Number, C/O)Address1D CaseNumber Uppercase/Enter the Case Number (Example: V1234567A,B,C)D ClientCity UppercaseEnter the Addressee's City. ClientStateD ClientState Uppercase1Enter the Addressee's 2 digit State Abbreviation. ClientZipD ClientZip UppercaseKEnter the Addressee's Zip Code (+4 if known) (Example: 48909 or 48909-7537)D CoAddress UppercaseaEnter the County's mail address (street address, PO Box, etc., where the mail will be delivered).D CoAreaCodeEnter the County's Area CodeDCoCity UppercaseEnter the County's City.D CoExtensiond`CJOJQJ_HmH sH tH ROR Bureau?d8(5OJQJ_HmH sH tH \O\ WorkerName2@d8(5OJQJ_HmH sH tH PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! 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WorkerPhone!/Address1CareOf CaseNumber ClientCity ClientState ClientZip CoAddressCoCity CoExtension CoPhoneNumberCoState CoSuppaddress CountyNameCoZip1Normal FirstName FirstName2GranteeAddress1 GranteeCareof GranteeCityGranteeFirstNameGranteeLastName GranteeState GranteeZipLastName LastName2OtherIDSuperExtensionSuperPhoneNumberSupervisorNameWorkerExtension WorkerFax WorkerName WorkerPhone CoAreaCode CountyNumberDate1DistrictFaxACGranteeClientIDSection SuperAreaCodeUnitWorkerWorkerAreaCodeBureau WorkerName2(<Pdu$5I]n)=Qey%9M^o~ ?EB &*/4F8Z:=WLKt4Z:`b cr8tuu %(+/48>DIPU[ahty @ P @ ]++}>J > J K#$Z%2&&&&&*Y+J,,,W.0X24|44444~7[839:>:J:X:;X<>=l== >Dr < BF DPVbh((,[%223\33F4455V9:bpdru!"#$&')*,-.01235679:;<=?@ABCEFGHJKLMNOQRSTVWXYZ\]^_`bcdefgipqrsuvwxz{|}~  &(4:<HNP\bdpsu"$035AGIU[]il !')5;=IOQ]ceqwy #%179EKMY\^jmo{FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF.Address1BureauCareOf CaseNumber ClientCity ClientState ClientZip CoAddress CoAreaCodeCoCity CoExtension CoPhoneNumberCoState CoSuppaddress CountyName CountyNumberCoZipdate1DistrictFaxAC FirstName FirstName2GranteeAddress1 GranteeCareOf GranteeCityGranteeClientIDGrenteeFirstNameGranteeLastName GranteeState GranteeZipLastName LastName2OtherIDSection SuperAreaCodeSuperExtensionSuperPhoneNumberSupervisorNameUnitWorkerWorkerAreaCodeWorkerExtension WorkerFax WorkerName WorkerName2 WorkerPhone)=Qev%6J^*>Rfz&:N_p  !"#$%&'()*+,-';Oct#4H\m(<Pdx$8L]nz4`bdrUnknown G* Times New Roman5Symbol3. * Arial?= * Courier New9 WebdingsI" Arial (W1)Arial5. *aTahomaA$BCambria MathS.Arial Rounded MT Bold7Tms Rmn"h0@P?z2!xx