The West Virginia Department of Health and Human Resources, Bureau for Social Services has developed a process for families to apply for reimbursement of unexpected fees directly related to the delay in foster care, adoption, legal guardianship, and adult services payments for the month of February.
Acceptable documentation that must be provided with the form includes:
- a copy of the statement showing the late charge/fee (please circle the charge for clarity),
- a copy of the statement from the bank or financial institution showing overdraft fees, or
- other documentation such as utility bills, medical bills, payment receipts, etc., showing accrued late charges, and
- a completed W-9.
Completed forms and documentation must be mailed to Commissioner Jeffrey Pack, Bureau for Social Services, 350 Capitol Street, Room 730, Charleston, WV 25301.