INDIAN NATION PROGRAM AGREEMENT For Tribal Participation in Title IV-E Program - Federal Payments for Foster Care and Adoption Assistance DSHS Agreement Number ContractNoIndian Nation Program Agreement • October 10th, 2020
This Program Agreement is by and between the State of Washington Department of Social and Health Services (DSHS) and the Indian Nation identified below, and is issued in conjunction with an Indian Nation and DSHS Agreement Regarding General Terms and Conditions, which is incorporated by reference. Administration or Division Agreement Number Indian Nation Agreement Number
INDIAN NATION PROGRAM AGREEMENT Operational Agreement to Provide Foster Care and Adoption Services under Title IV-E Funding Program DSHS Agreement Number ContractNoIndian Nation Program Agreement • December 14th, 2020
This Program Agreement is by and between the State of Washington Department of Social and Health Services (DSHS) and the Indian Nation identified below, and is issued in conjunction with an Indian Nation and DSHS Agreement Regarding General Terms and Conditions, which is incorporated by reference. Administration or Division Agreement Number progcontno Indian Nation Agreement Number
INDIAN NATION PROGRAM AGREEMENT Tribal Qualified Health Home HCA CONTRACT NUMBER: «F1» ECMS REFERENCE NUMBER:Indian Nation Program Agreement • September 17th, 2020
This Contract is by and between the State of Washington Health Care Authority (“HCA”) and the Contractor identified below Contractor Contract Number:
ContractIndian Nation Program Agreement • March 28th, 2018
INDIAN NATION PROGRAM AGREEMENTTreasury Offset - Tribal IV-D Program DSHS Agreement Number This Program Agreement is by and between the State of Washington Department of Social and Health Services (DSHS) and the Indian Nation identified below, and is issued in conjunction with a DSHS and Indian Nation Agreement on General Terms and Conditions, which is incorporated by reference. Administration or Division Agreement Number Indian Nation Agreement Number DSHS ADMINISTRATION Economic Services Administration DSHS DIVISION Division of Child Support DSHS INDEX NUMBER CCS CONTRACT CODE 3000NC-62 DSHS CONTACT NAME AND TITLE Tribal Relations TeamProgram Administrator DSHS CONTACT ADDRESS 712 Pear St SE PO Box 9162Olympia, WA 98507-9162 DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL INDIAN NATION NAME Tribe Name INDIAN NATION ADDRESS INDIAN NATION FEDERAL EMPLOYER IDENTIFICATION NUMBER INDIAN NATION CONTACT NAME INDIAN NATION CONTACT TELEPHONE INDIAN NATION CONTACT FAX INDIAN NATI
ContractIndian Nation Program Agreement • April 2nd, 2014
INDIAN NATION PROGRAM AGREEMENTFederal Offset Certification for Tribal Child Support Programs DSHS Agreement Number This Program Agreement is by and between the State of Washington Department of Social and Health Services (DSHS) and the Indian Nation identified below, and is issued in conjunction with the DSHS and Indian Nation Agreement on General Terms and Conditions, which is incorporated by reference. Administration or Division Agreement NumberDSAIndian Nation Agreement Number DSHS ADMINISTRATION Economic Services Administration DSHS DIVISION Division of Child Support DSHS INDEX NUMBER CCS CONTRACT CODE DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS P O Box 9162Olympia, WA98507-9162 DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL INDIAN NATION NAME (Tribe) INDIAN NATION ADDRESS Address City, WA Zip INDIAN NATION FEDERAL EMPLOYER IDENTIFICATION NUMBER (number) INDIAN NATION CONTACT NAME (Name, Title) INDIAN NATION CONTACT TELEPHONE () - Ext: INDIAN NATION CONTACT FAX
