MISSOURI DEPARTMENT OF SOCIAL SERVICES CHILDREN’S DIVISION REQUEST FOR POLICY INTERPRETATION
BEFORE COMPLETING THIS FORM, PLEASE READ THE INSTRUCTIONS.
TO	CENTRAL OFFICE The completed CS-77 is to be sent via e-mail to: CD.PolicyInte@dss.mo.gov or faxed to 573-526-3971.	FILE NO.
FROM	NAME	PHONE NO.	EMAIL ADDRESS
REVIEWED & SUBMITTED BY	DATE OF REQUEST
REGION/ Private Agency	COUNTY
PROGRAM	CHILD WELFARE MANUAL REFERENCE
QUESTION
RESPONSE
Program Development Specialist Signature	Date
Deputy Director Signature	Date	Intranet Posting Yes No