016.20.99 Ark. Code R. 018 - Income Maintenance Form (IMF) 99-8: Revised Form DCO-116 - Client Statement Regarding Absent Parent
Click here to view image
Click here to view image
INSTRUCTIONS FOR DCO-116
Purpose
Form DCO-116, Client Statement Regarding Absent Parent, is used to collect information from the Medicaid client about an absent parent.
Completion
The DCO-116 is an optional form to be used when securing absent parent information through the mail.
The DCO-116 may be completed by the county office worker or by the client.
Retention
The DCO-116 will be filed in the forms section of the case record and retained for three years.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.