PS 217 F1-Application Affidavit-of-Informal-Kinship-Care- Fillable 2026

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  1. Click ‘Get Form’ to open the PS 217 F1 in our editor.
  2. Begin with Part I, where you will enter your name and confirm that you are over eighteen years of age. This section establishes your eligibility as the applicant.
  3. Indicate your kinship relation to the child by filling in the appropriate field. Ensure that you are related by blood or marriage within the fifth degree.
  4. Provide the child's name and date of birth. Then, check all applicable serious family hardships from the list provided, ensuring you attach supporting documentation for each checked item.
  5. Fill in your address and contact information accurately, including phone numbers and email addresses for effective communication.
  6. Complete any additional sections regarding the child's schooling and special education services, if applicable.
  7. Finally, sign and date the affidavit at the bottom of Part I to affirm that all information is true to your knowledge.

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The Medical Plan Affidavit will require the spouse to indicate if they are employed. If the spouse is employed, the spouses employer will be required to complete the Medical Plan Affidavit to confirm that the spouse is not eligible for group medical coverage with their employer.
Consent for Health Care -Affidavit Provision provides for a relative of a child providing informal kinship care to consent to health care on behalf of the child. The relative must be able to verify the informal kinship care arrangement through an affidavit. To receive this form, Call 410-767-7249.
The consent form is intended, in part, to provide information for the potential subjects current and future reference and to document the interaction between the subject and the investigator. However, even if a signed consent form is required, it alone does not constitute an adequate consent process.

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An Affidavit of Consent is a legal document that you can use to agree to move forward with a no-fault divorce. In some states, its a required first step for this type of divorce, where both spouses agree that the other spouse isnt at faultin other words, neither spouse caused the divorce.
Informal kinship care means a living arrangement in which a relative of a child, who is not in the care, custody, or guardianship of the local department of social services, provides for the care and custody of the child due to a serious family hardship. Legal custody is not required.

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