CC-213 (New 6 19) 2026

1. Click ‘Get Form’ to open the CC-213 (New 6 19) in the editor.
2. Begin by selecting whether you are a Parent/Applicant or a Service Provider. Fill in the Child's Name, Date of Birth, and SSN in the designated fields.
3. Complete the Applicant and Co-Applicant sections with names and dates of birth. Ensure all required fields are filled accurately.
4. Indicate the Race and Ethnicity for both the child and applicants by checking the appropriate boxes.
5. In the Housing/Living Status section, check the relevant status for the child. If applicable, provide additional details such as mailing address.
6. Check any applicable statements regarding employment or schooling status, ensuring to fill in any additional information requested.
7. Review the Parent/Applicant Certification section carefully before signing and dating it. Ensure all information is accurate to avoid issues later.
8. If applicable, have your Service Provider complete their certification section with signature, date, name, and title.

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