Family Financial Statement
Charles County Department of Social ServicesFinancial Disclosure FormThis form documents household income, expenses, assets, and financial stability for resource parent assessment.
Family Financial Statement
This form will be processed by your selected caseworker and used for financial assessment.
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Caseworker Selection

Select your assigned caseworker

Important Notice

Please select your assigned caseworker(s) from the list below. You can select multiple caseworkers if needed. If you are unsure who your caseworker is, please contact CCDSS at (301) 609-6000 before proceeding.

This form will be sent to your selected caseworker(s) for processing.