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How to use or fill out Sacramento County Stage One Child Care - Request for Reimbursement 2145 Form with DocHub
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Click ‘Get Form’ to open it in the editor.
Begin by filling out Section 1 and Section 2, which are designated for parent information. Enter your name, contact details, and your child's information including their date of birth and age.
In Section 3, provide the child care provider's details. Specify the type of provider and enter their billing address along with the relevant rates for care.
Proceed to Section 4, where you will summarize the billing. Ensure that all hours and days match what is recorded on the back of the form. Use decimals for amounts if completing electronically.
Sign and date both sides of the form after ensuring all information is accurate. Remember to submit it within three months of care completion to avoid payment denial.
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Enter the Full Name, Date of Birth, and Age of the child in each section. Enter the School Name, Track, and Grade if the child is in a preschool program separate from daycare, or if the child is Kindergarten thru high school. Complete the Travel Time each way from child care to the parent activity.
How to fill out a withholding certificate?
Note: The W-4 form 2024 steps are the same as the W-4 form 2025 steps. Step 1: Enter your personal information. Step 2: Account for all jobs you and your spouse have. Step 3: Claim your children and other dependents. Step 4: Make other adjustments. Step 5: Sign and date your form.
How much will my relative child care provider get paid for keeping my child in California?
Average Child Action Childcare Provider hourly pay in California is approximately $27.58, which is 82% above the national average.
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Oct 20, 2025 Once approved for Stage One Child Care, all CCP 2145 forms must be submitted within three (3) months after care takes place. Any forms received
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