TA Paper Forms
Paper copies of some forms are still necessary. These are primarily informational brochures. Provide copies of the appropriate forms to customers as required. Not every form is required for each application.
To download the latest Word version of each form, or for instructions on form completion, see the Forms Manual on the employee intranet. Some forms or instructions are available in .pdf format. Links are provided below.
| CS-1* | What’s This About Child Support |
| CS-6* | What it Means to Establish Paternity for Your Child |
| CS-201 (instructions) | Referral/Information for Services |
| IM-1TA | Application for Temporary Assistance Cash Benefits** |
| IM-1TASF | Application for Temporary Assistance (short form) |
| IM-16 | Communication Transmittal |
| IM-2E(Part 1) | Cooperation/Good Cause Notice |
| IM-2E(Part 2) | Second Notice |
| IM-2EH (instructions) | Extension for Hardship |
| IM/CS-2PV* | Voluntary Paternity Establishment Handout |
| IM-3EBT (instructions) | Important Information About Electronic Benefit Transfer (EBT) Transactions |
| IM-3 Orientation | Temporary Assistance Orientation (attestation) |
| IM-3 PRP | Personal Responsibility Plan |
| IM-3TADrug | Temporary Assistance Drug Testing Applicant Notice |
| IM-4EBT*(instructions) | Electronic Benefits Transfer |
| IM-4 Fraud Pamphlet* (instructions) | Information You Need About Fraud |
| IM-4Hearings* (instructions) | Important Information About Your Hearing Rights |
| IM-6AR | Appointment of Authorized Representative |
| IM-6ARR | IM Authorized Representative Revocation |
| IM-20 | Agreement for Direct Deposit |
| IM-41TA | TANF Months Used (out of state) |
| Know Your Rights brochure* | Missouri Consumer Guide from the Attorney General’s Office |
| MO 231-0167 (instructions) | Missouri Voter Registration Application |
| MO 886-4061 | Notice of Privacy Practices Regarding Health Information |
| SSN-1 | Referral for SSN Application |
| TA Diversion Transmittal | Temporary Assistance Diversion Transmittal Form |
| VS-465 (original form required) | Affidavit Acknowledging Paternity |
| VS-465D (original form required) | Husband’s Denial of Paternity |
| VS-465F (original form required) | Father’s Affadavit Acknowledging Paternity |
| VS-465M (original form required) | Mother’s Affadavit Acknowledging Paternity |
| WIC Balloon Brochure* | WIC (Women, Infants and Children) Program |
*Forms identified with an asterisk are for informational use only. They are provided to the customer – not filed in the case record.
**IM-1TA incorporates the following forms: IM-3 TADRUG; IM-3 EBT; IM-3 Orientation; IM-3 PRP; IM-2E part 1; CS-201; MO 231-0167 Voter Registration; IM-4 Hearings; IM-20