New sending case

Request a placement in another state

Step 5 of 5

Review & send

Case

Sending agency
Nevada ICPC Central (DCFS)
Sending county
Carson City
Receiving agency
PA DHS – ICPC Office
Receiving county
Dauphin
Reg Type
REG 1 - Intact Family Relocation
Type of care
Relative (Not Parent)
Case type
Public
Subsidy
—

Children (1)

  • Maya ThompsonBorn 04/12/2016 · Sending Agency Custody/Guardianship · Aunt to Sunrise Children’s Home

Placement resource

Sunrise Children’s Home PR-4521 · Organization

Prospective adoptive or foster resource: Harry Sean · Marcus, Florida

Form 100A

Planning
Nevada ICPC Central (DCFS)
Financial
Linda Thompson
Supervision
Other – Monthly video visit with the child
Reports
Quarterly
Enclosures
3 documents
Signed by
Sam Ortiz

Case documents

  • Form 100A – Maya Thompson.pdfForm 100A · Added 11/10/2026
  • Supporting document 1.pdfUpload · Added 11/10/2026

Transmittal

Goes to Pennsylvania with the 100A.

Transmittal for child(ren)
Purpose of transmittal
CC (people in your state only)
Enclosed documents
Message about child(ren)
User(s)
Documents associated

Send to Pennsylvania

Pennsylvania will receive the 100A for each child, with the enclosed documents. You can follow progress on the case.