LDSS-4623. Adoption Subsidy Agreement And Non-Recurring Adoption Expenses Agreement - Cover Sheet

Form LDSS-4623 Adoption Subsidy Agreement And Non-Recurring Adoption Expenses Agreement - Cover Sheet is a form used by the New York State Office of Children and Family Services to facilitate the adoption of a child. It is used to provide financial assistance to the adoptive family to help cover the costs associated with an adoption. The form consists of several sections, including the adoptive family's contact information, information about the adopted child, the adoption expenses to be covered, and the financial assistance provided by the state. The form also includes signatures from the adoptive family, the adoption agency, and representatives from the state.

Important fields in this form include the adoptive family's contact information, the adopted child's name and date of birth, the amount of financial assistance requested, the amount of financial assistance approved, and the signature of the adoptive family. It is important to complete the form accurately, as any inaccurate information may lead to the form being denied or delayed.

An example scenario of when this form would be used is when an adoptive family is looking to receive financial assistance from the state to cover the costs associated with the adoption. The form provides the state with the necessary information to approve or deny the family's request for financial assistance, and the benefits of using the form include receiving financial support to help cover the costs of an adoption.

When filling out the form, it is important to provide accurate and complete information, as any inaccuracies or omissions may lead to a delay or denial of the financial assistance request. Additionally, there are related forms that may be used in conjunction with this form, such as an Adoption Agreement and a Non-Recurring Adoption Expenses Agreement. Additional documents may also be necessary depending on the situation.