Indiana
Applicant Job Search Rights and Responsibilities 48191
No One Left Outside provides source-based information. The issuing agency or plan decides eligibility, acceptance and availability.
Source / last checked DFR: Forms - 2026-11-02
- Form number
- 48191
DFR: Forms - Reviewed 2026-11-02
- What it is for
- Applicant Job Search Rights and Responsibilities 48191
DFR: Forms - Reviewed 2026-11-02
- Issuing agency
- Indiana Family and Social Services Administration (FSSA); this form appears in the DFR forms catalog.
DFR: Forms - Reviewed 2026-11-02
- Program
- IMPACT job training
DFR: Forms - Reviewed 2026-11-02
- Jurisdiction
- Indiana
DFR: Forms - Reviewed 2026-11-02
- Category
- JOB SEARCH
Applicant Job Search Rights and Responsibilities 48191 - Reviewed 2026-11-02
- Form type
- form
DFR: Forms - Reviewed 2026-11-02
- Who fills it out
- Applicant
Applicant Job Search Rights and Responsibilities 48191 - Reviewed 2026-11-02
- How to submit
- Not listed yet. Call to confirm.
- Documents to include
- Not listed yet. Call to confirm.
- Languages
- English
Applicant Job Search Rights and Responsibilities 48191 - Reviewed 2026-11-02
- Official page
- https://www.in.gov/fssa/dfr/forms-documents-and-tools/forms
DFR: Forms - Reviewed 2026-11-02
- Direct form link
- https://forms.in.gov/Download.aspx?id=5457
DFR: Forms - Reviewed 2026-11-02
- Revision date
- R4 / 6-17
Applicant Job Search Rights and Responsibilities 48191 - Reviewed 2026-11-02
- Signature
- I have read, or have had read to me, the above Rights and Respo nsibilities. I understand that any questions I may have regardi ng the above information will need to be directed to my Applicant Job Search Case Manager. My signature below indicates receipt of th is Agreement and notification of my next appointment. I ALSO UNDERSTAND THAT IF I FAIL TO MEET ONE OF THE RESPONSIBILITIES LISTED ABOVE, I MUST PROVIDE “GOOD CAUSE” IN WRITING TO AVOID HAVING MY APPLICATON FOR TANF DENIED. Signature of applicant Date signed (month, day, year)
Applicant Job Search Rights and Responsibilities 48191 - Reviewed 2026-11-02
- Accessibility
- I have read, or have had read to me, the above Rights and Respo nsibilities.
Applicant Job Search Rights and Responsibilities 48191 - Reviewed 2026-11-02
- What the form says
This form is CONFIDENTIAL according to 470 IAC 1-2-7; 470 IAC 1-3-1; and 470 IAC 6-1-1.
Applicant Job Search Rights and Responsibilities 48191 - Reviewed 2026-11-02
Check the form number and revision before using it. Read the agency's privacy and consent terms before sharing personal information.