Form Aap 8 Adoption Assistance Program Nonrecurring Adoption Expenses Agreement
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1STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
ADOPTION ASSISTANCE PROGRAM
NONRECURRING ADOPTION EXPENSES AGREEMENT
Adoptive parents may be reimbursed for nonrecurring adoption expenses of up to $400 per adoption of
a special needs child pursuant to Welfare and Institutions Code (W&IC) Section 16120.1. The term
"nonrecurring adoption expenses" is defined as the reasonable and necessary adoption fees, court
costs, attorney fees and other expenses which are directly related to the legal adoption of a child with
special needs, which are not incurred in violation of State or Federal law, and which have not been
reimbursed from other sources or funds.
Other allowable costs of the adoption incurred by or on behalf of the parents and for which parents carry
the burden for payment, may include: the adoption homestudy, health and psychological examinations,
supervision of the placement prior to the adoption, transportation and reasonable costs of lodging and
food for the child and/or the adoptive parents when necessary to complete the adoption process.
To be eligible for nonrecurring adoption expenses the child must meet the three part special needs
determination and be a United States citizen or qualified alien as stated in W&IC Section 16120 (a)
through (c) and (l).
Financially Responsible County:______________________Adoptive Placement Date: ____________
Name
I/We, ____________________________________and _____________________________, have
Name of Parent
Name of Parent
entered into an agreement with the _________________________________ for the Nonrecurring
Responsible Public Agency
Adoption Expense Reimbursement Amount of $____________ for _________________________
Name of Child
Claim for payment including receipts and all related nonrecurring adoption expenses
documentation is attached.
Or
I/We, ________________________ and ________________________, have been notified that we
Name of Parent
Name of Parent
may be eligible to receive these funds and the claim for payment including receipts and all related
nonrecurring adoption expenses documentation will be submitted to _________________________
Responsible Public Agency
no later than two years from date of finalization.
Adoptive Parent
Date
Adoptive Parent
Date
Child’s Agency Representative
Date
Child’s Agency Name
AAP 8 (5/15)
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