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- Click ‘Get Form’ to open the dss form in the editor.
- Begin by completing Section 1A: Provider Information. Fill in the name of your facility, owner, and director. Ensure you provide the Facility FEIN No. or Owner’s Social Security No., along with the complete street address and contact details.
- In Section 1B, answer questions regarding participation in programs like ABC Child Care and USDA Food Program. Check the appropriate boxes for meal preparation methods and confirm if your facility policies have been updated.
- Proceed to certify your application by signing and dating where indicated. Make sure all information is accurate to avoid delays.
- If applicable, complete any additional sections on the back of the form as required by DSS licensing staff.
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dss form 2901
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