Self Service Forms Center
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Choose from the below list to access important benefits and support forms and a variety of other Champaign County DJFS resources. If you don't find what you need here, contact us by e-mail or call 484-1500.

 COVID-19 PRC Forms :  

The PRC COVID-19 Application and W-9 must be completed in full. If available, provide verification of loss of employment to avoid application processing delays. All loss of employment will be verified. 

PRC Plan including COVID-19 Funding

COVID-19 PRC Application


Food and Medical Forms:

Request to Apply for Cash, Food, and Medical Assistance (JFS 7200)

Request to Reapply for Cash & Food Assistance

Interim Report for Cash & Food Assistance

Declaration of Circumstances

Employment Verification

Statement of Support

PRC Forms:

PRC Packet

PRC Application

PRC Household Budget Sheet

Child Support Forms:

Child Support IV-D Application for Services

Child Support Review & Adjustment request