Form 3004


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What is Form 3004?

Form 3004 is also known as the South Carolina Voucher Program Child Protective Services/Foster Care Child Care Referral Form. This is an official document that is provided by the case manager and under the supervisor’s attention. The form has to be recorded by the South Carolina child protective services. If you are a resident of another state, you will find a similar document available in your own state. This one must be filled by South Carolina residents only. It is the referral that is filled by the authority who is obliged to check up on the foster house and make sure that the child care works. In case the time in the house must be extended, the case manager needs to fill a specific section of the form.

The government authority has to confirm the document before the case manager will be able to move to the steps that were discussed there. The document will be kept by the department of social services. It can’t be filled by the foster family or child.

Form 3004 on PDFLiner

What I need the Form 3004 for?

  • The form 3004 voucher is widely used by the representatives of social programs that protect children in foster care. This is the referral document for the child care program in South Carolina that must be filled by the case manager responsible for the child’s safety in the foster care house;

  • This document must be submitted to the South Carolina Department of Social Services and kept there as the record that proves that the child lives in the mentioned house and the care was extended. This document can also signal the urge to transport the child to another family that provides foster care as well.

How to fill out Form 3004?

There is nothing complicated in filling out the form SC-3004. However, not everyone can fill it. You need to be responsible for the specific case of child care before you will be allowed to send the template to authorities. You also need to get the signature of the supervisor as well. The signed form must be sent to the Department of Social Services. There is no deadline for the form. You can fill it out online using the tools that PDFLiner offers you. You will be able to work with PDF documents there. Once you fill it, save it on your device. You can print the document as well. If you need, you may hand the printed copy to the supervisor or send it via email based on the demands. Here is what you need to include there:

  1. Pick the appropriate type of your case and put the tick in the matching box;

  2. Provide information on the county, name of the parent, SSN, and child’s relations;

  3. Provide information on the care provider that works with the child, including name, SSN, and address;

  4. Share the child’s information, including name, birth date, SSN, and time the child spent in the child case;

  5. Put the date when you sign the form, and provide the address and name of the child care provider;

  6. Put the ticks in the matching boxes near the statements about the child;

  7. Name the reasons for the extension of the service if it is your case;

  8. Put signatures and dates.

Organizations that work with Form 3004

  • South Carolina Department of Social Services.

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Fillable online Form 3004
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