How to Fill Out ICPC Form 100A: Sections, Packet, and Signatures

To fill out ICPC Form 100A, a caseworker or placing agency completes Sections I through III — the child’s identifying data, the placement classification, and the enclosures checklist — then routes the signed form with its supporting packet through the sending state’s ICPC office; the receiving state’s compact administrator completes Section IV after the home study. The current standardized form used by all 50 states, the District of Columbia, and the U.S. Virgin Islands is available from the American Public Human Services Association (APHSA).¹ No child may be placed across state lines until administrators in both states have signed.

A separate 100A must be completed for each child, even siblings going to the same home.² Errors in the identifying data and placement classification are the most common reason packets get returned without action, so take the first two sections slowly.

Section I: Identifying Data

Enter the child’s full legal name, Social Security number, sex, date of birth, ethnic group, and Indian Child Welfare Act (ICWA) eligibility status.

Then list the legal mother and legal father. In most cases these are the birth parents, but if an earlier adoption was finalized, the adoptive parents go here instead. Write “deceased” after the name of a deceased parent. If parental rights have been voluntarily relinquished or terminated by a court, note that in parentheses next to the name, or, if the agency prefers to withhold the name, simply state the status of the parent’s rights.²

Declare the child’s legal status by selecting one option:

Sending Agency Custody/Guardianship — the public agency holds legal custody or guardianship.
Parent/Relative Custody/Guardianship — a parent or relative retains legal custody.
Court Jurisdiction Only — the court has jurisdiction but no agency holds custody, common when a judge orders a home study on an out-of-state relative.
Parental Rights Terminated, Right to Place for Adoption — the agency has completed court action terminating parental rights and holds the right to place for adoption.
Protective Supervision — the agency supervises the family under a court order.

Finally, mark whether the child is Title IV-E eligible: Yes, No, or Pending. This drives federal reimbursement for foster care maintenance payments and shapes the financial plan you attach to the packet.³

Section II: Placement Information

First, mark whether the placement is Public (processed through a public child welfare agency or court) or Private (arranged by a parent, private agency, or independent representative, such as in a private adoption). Then choose the type of care:⁴

Adoptive Home, covering both agency and private/independent placements before finalization.
Foster Family Home — a licensed or approved home providing 24-hour care for a child not related to the caretaker, including certified kinship care homes.
Group Home Care — a licensed facility serving more children than a foster home but fewer than an institution.
Child-Caring Institution — a larger group care facility licensed for custodial care.
Residential Treatment Center — a facility providing a specific treatment program outside a medical or psychiatric hospital.
Institutional Care (Article VI), Adjudicated Delinquent — for delinquent youth placed under Article VI of the compact.
Relative (not parent) — specify the exact relationship, such as grandparent, aunt, or adult sibling.

The category you pick determines the type of home study the receiving state will conduct and the licensing standards the placement must meet. Marking “Foster Family Home” when the placement is actually with an unlicensed relative, for example, will get the packet bounced back.

For private or independent adoption cases, also complete the prospective adoptive parents’ names, address, Social Security numbers, and telephone numbers in Section II. Public agency adoptions do not require this extra identifying information about the resource family here.

Section III: Services Requested and Enclosures

Section III is a checklist. Indicate what services you are requesting from the receiving state — typically a home study — and check off the documents enclosed. Standard enclosures are the child’s social history, the court order, a financial/medical plan, Title IV-E eligibility documentation, and any existing home study of the placement resource. Check the ICWA enclosure box when applicable.³

The caseworker and the sending state’s compact administrator (or deputy) both sign below Section III and date it. For Court Jurisdiction Only cases, the judge typically must also sign.

Section IV Is Not Yours to Fill

Section IV belongs entirely to the receiving state’s compact administrator, who checks either “Placement may be made” or “Placement shall not be made” after the home study, adds any remarks, and signs.⁵ Leave it blank. The current standardized form ends at Section IV; there is no Section V, despite older references that mention one.⁶

The Packet That Goes With the Form

The 100A by itself is not enough. It must travel with a supporting packet that gives the receiving state enough information to evaluate the placement. Missing or outdated items are the most frequent reason requests stall. Assemble:

The child’s social history — a narrative covering background, behavioral and medical needs, education, and prior placements.
The current court order establishing the agency’s or court’s authority. Some states require it to be dated within the past 12 months.
A financial/medical plan explaining how daily expenses, foster care payments or subsidies, and medical coverage (Medicaid or private insurance) will be handled in the new state.⁷
Title IV-E eligibility documentation under the federal Social Security Act. If eligibility is still pending, say so and include whatever documentation you have.
Copies of the birth certificate and Social Security card.
Medical records, including immunizations.
School records, if the child is school-aged.
ICWA documentation for any child who is or may be eligible under the Indian Child Welfare Act. The placing agency must verify compliance with ICWA placement preferences — which prioritize extended family, other members of the child’s tribe, or other Indian families — before the compact administrator signs. The compact administrator has an independent duty to verify ICWA compliance, and the ICWA enclosure box in Section III should be checked with tribal documentation attached.⁸

Some states also require a case plan, verification of paternity when the request involves a biological father not listed on the birth certificate, and an acknowledgment form for relative or kinship caregivers. Check your state’s ICPC office for anything layered on top of the national standard.

Where the Form Goes After You Sign It

The 100A follows a set chain of custody. The local caseworker prepares the form and packet and sends everything to the sending state’s central ICPC office. That office reviews the materials for completeness; if anything is missing or inconsistent, the packet comes back to the caseworker. Once the sending state’s compact administrator approves it, the packet moves to the receiving state’s central ICPC office.

Most states now transmit ICPC paperwork through the National Electronic Interstate Compact Enterprise (NEICE), a secure system that replaced the old paper-mail process. As of mid-2024, 47 states and jurisdictions were fully operational in NEICE, with the remainder using a secure portal or committed to joining.⁹ Electronic submission cuts weeks off the process.

Federal law gives the receiving state 60 days to complete the home study and return a written report under the Safe and Timely Interstate Placement of Foster Children Act of 2006.¹⁰ The child cannot legally travel to the new placement until the sending state receives the 100A back with Section IV signed favorably.

Requesting Expedited Handling Under Regulation 7

For certain urgent placements with relatives, Regulation 7 shortens the decision window to 20 business days. The case qualifies if the child is being considered for placement with a parent, stepparent, grandparent, adult sibling, adult aunt or uncle, or guardian, and at least one of the following applies:¹¹

Unexpected dependency: a parent or guardian was recently incarcerated, incapacitated, or died.
The child is four years old or younger, including older siblings going to the same resource.
A court has found the child has a substantial, established bond with the proposed caregiver.
The child is currently in an emergency placement.

The 20-business-day clock starts when the receiving state’s compact administrator receives the completed materials. Flag the Regulation 7 request clearly on the 100A and in your cover letter. It will not be treated as expedited unless you ask.

What Happens After Approval: Form 100B

Approval on the 100A gets the child to the placement. Form ICPC-100B handles everything afterward. Once the child physically arrives, the sending agency files a 100B to confirm the placement and the exact date it occurred. A new 100B is required whenever something changes: the child moves to a different address, the type of care shifts from foster care to adoption, or the placement resource changes. If you open a case through the ICPC, you must close it through the ICPC with a final 100B.¹²

The 100B is also the form to withdraw a placement request before the home study is done, or to notify both states that an approved resource will not be used. Failing to file 100B updates leaves the case open indefinitely in both states’ systems.

Do Not Move the Child Before Section IV Is Signed

Moving a child across state lines before the receiving state signs the 100A violates Article III of the compact. The sending agency then bears full liability for the child’s safety, the receiving state can demand immediate removal, and the receiving state may (but is not required to) proceed with the home study while the child is placed illegally, meaning it can refuse to evaluate the placement until the child is brought back.¹¹

All parties in an illegal placement — including prospective resource parents, the sending agency, any private licensed agency, and legal counsel — must notify the ICPC offices in both states and coordinate to protect the child while the situation is resolved. In private adoption cases where the child was placed before ICPC approval, file a 100B stating the date the child was placed, along with all required supporting documents; both states will then evaluate whether to allow the placement to continue under their respective laws.

1
American Public Human Services Association. ICPC Resources
2
New York State Office of Children and Family Services. Instructions for Completing Form ICPC-100A
3
South Dakota Department of Social Services. ICPC 100A – Interstate Compact on the Placement of Children Request
4
North Carolina Department of Health and Human Services. Instructions for Completing ICPC Form 100A
5
West Virginia Department of Human Services. ICPC Form 100A
6
North Carolina Department of Health and Human Services. ICPC Form 100A
7
California Department of Social Services. ICPC Forms and Documents
8
American Public Human Services Association. Interstate Compact for Placement of Children and the Indian Child Welfare Act
9
American Public Human Services Association. National Electronic Interstate Compact Enterprise
10
Administration for Children and Families. Information Memorandum IM-06-03
11
American Public Human Services Association. Interstate Compact on the Placement of Children Regulations
12
South Dakota Department of Social Services. ICPC-100B Interstate Compact Report on Child’s Placement Status