Request for Youth in Transition Funds Checklist
Michigan Department of Health and Human Services
This form must be completed for every YIT or MYOI-YIT request and kept in the financial section of the case file or uploaded into the Service Authorization section of MiSACWIS.
Youth’s Name	Date of Birth
MiSACWIS Person ID	Amount Requested
Type of YIT case:	Is the amount requested over $600?
Open	Closed	Yes	No
If yes, is a DHS-720 completed with a county director/designee’s signature authorizing expenditure over $600? (A DHS-720 does not need to be completed for rent/security deposit and household startup goods expenditures over $600.)	Yes	No
Is the YIT request policy approved? (See FOM 950 for a detailed list of approved expenditures.)	Yes	No
If no, is a DHS-720 completed with a program office signature authorizing the policy exception?	Yes	No
If the expenditure is not listed as an approved expenditure in FOM 950, a DHS-720 must be completed and submitted with supporting documentation for approval PRIOR to expenditure. Documentation can be submitted by email to MDHHS-YouthInTransition@michigan.gov.
Describe the expenditure requested.
Describe why the expenditure is needed and how it will assist the youth towards self-sufficiency and independence.
Note: Use of YIT funds for post-secondary education expenses is prohibited for students eligible for or receiving ETV funding. YIT purchases made from MDHHS directly to the vendor are tax-exempt with the exception of vehicle purchases. See FOM 950 for further information.
Lifetime Limit Expenditures
Computer Limit (up to $1500):	First Month’s Rent/Security Deposit Limit (up to $1500):
Parenting start up goods (up to $500)
Startup Goods Limit (up to $1000):	6 Months Care Insurance Limit:
Vehicle Limit (up to $5000):	Vehicle Repairs Limit (up to $900):
Will this expenditure request exceed the lifetime limit?	Yes	No
If yes, a DHS-720, Policy Exception Request must be authorized by Program Office.
Date of Program Office approval:
The following documentation is located in the case file:
Birth Certificate	Court Order
DHS-5329 (if applicable)	MiSACWIS YIT eligibility or DHS-722
Check all required documentation
Invoice or Original Receipt	Housing Lease
MiSACWIS Service Authorization or DHS-4713	MDHHS-5602 or Procurement Card Log
Vehicle Documentation (includes documentation of valid driver’s license, automobile insurance quote, ability to maintain payments, insurance and other expenses, and a vehicle inspection supporting the purchase price.)
Note: After expenditure is completed, the original receipt must go to accounting with a copy being kept in the case file. Verification the youth received the funds must also be included in the case file.
I certify that before requesting YIT funds that I have attempted to utilize all other community/state/federal resources.
Foster Care Worker Name	Foster Care Worker Signature	Date
Foster Care Supervisor Name	Foster Care Supervisor Signature	Date
MDHHS Monitor Name	MDHHS Monitor Signature	Date
The Michigan Department of Health and Human Services (MDHHS) does not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, genetic information, sex, sexual orientation, gender identity or expression, political beliefs or disability.