North Carolina Department of Health and Human Services

Form DSS-5104, "Report to Central Registry / CPS Application," is a critical document issued by the North Carolina Department of Health and Human Services. It serves as a comprehensive tool for reporting incidents or suspicions of child abuse, neglect, or maltreatment to the Central Registry. This form also functions as an application for the Child Protective Services (CPS) program.

Main Uses: The primary uses of Form DSS-5104 include:

Form DSS-8227, used by the North Carolina Division of Social Services (DSS), explains what applicants need to know about citizenship, immigration status, and Social Security number requirements when applying for public assistance programs. Although it looks simple at first glance, it sets out several important legal rules that directly affect eligibility for Medicaid, Health Choice, Food and Nutrition Services, and Work First benefits. Understanding this form before submitting an application helps avoid delays, denials, and misunderstandings about how personal information is used.