ICPC Forms and Documents
What forms are needed in the ICPC process?
Required forms can be found at the bottom of the AAICPC Resources web page. Clicking on the link for each form will download a PDF version to your device.
- ICPC 100A:This form is the actual contract between the sending state and the receiving state. A placement cannot be made until the Compact Administrator or designee from both states has signed the
- Instructions for completing Form ICPC 100A.
- ICPC 100B:This form is used to inform the receiving state when a child is actually placed into their state, and to inform the receiving or sending state that an ICPC case has been closed.
- Instructions for completing Form ICPC 100B.
- ICPC Regulation 2 Social Worker Statement.
- ICPC 101 Regulation 7 Social Worker Statement.
What other documentation is needed for a public ICPC placement request?
- Court order or other written legal document as required to confirm Sending Agency’s authority to make the placement as defined in the ICPC Regulations (for dependent children/youth).
- Financial and medical plan (a detailed plan of the proposed method for support of the child and provision of medical services.)
- Title IV-E Eligibility verification (an explanation of the current status of the child's Title IV-E eligibility under the Federal Social Security Act and Title IV-E documentation, if available.)
- Social Worker Statement (for parent/relative/adoptive/foster placements).
- Service (case) plan (a comprehensive individualized program of action for a child and his/her family establishing specific goals and objectives and deadlines for meeting these goals and objectives).
- Summary of information on the child as defined in the ICPC regulations including a current case history for the child, including custodial and social history, chronology of court involvement, social dynamics and a description of any special needs of the child.
For definitions and specifics regarding forms and documentation see the complete ICPC Regulations.