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Click ‘Get Form’ to open the dhs 4025 form in the editor.
Begin by filling in the 'Case Name', 'Case Number', and 'Date' at the top of the form. Ensure accuracy as this information is crucial for processing.
In the 'DHS Office' section, enter the relevant office details along with your specialist's name, phone, fax, and ID. This helps in identifying your case.
Complete the 'Child Development and Care Provider Verification' section. Fill in your name, address, provider ID number, and contact details accurately.
List all children under your care in the designated area. Include their names, dates of birth, and indicate if you are related to them.
Both parent and provider must read and certify agreement to statements on page 2. Ensure signatures and dates are included before submission.
Once completed, return the form to your local DHS office specialist for processing.
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What is the maximum income for a child care subsidy?
CCS rates 2025-26 Family incomeSubsidy rate Up to $85,279 90% More than $85,279 to below $535,279 Between 90% and 0% The percentage decreases by 1% for every $5,000 of income a family earns $535,279 or more 0%
What are the income limits for kids Medicaid in Michigan?
If you are 18 or younger and your familys income is 217% of the Federal Poverty Guidelines (FPG) or less ($69,766 per year or less for a family of four), you may qualify for either Medicaids Healthy Kids or Healthy Kids/MIChild program.
What is the income limit for state assistance in Michigan?
Eligibility HouseholdMonthly Income* Four $3,138 Five $3,678 Six $4,218 Seven $4,7585 more rows
Does the state of Michigan pay for daycare?
Child Care Rates Once your rate is determined, MDHHS pays a portion of that rate based on your income. Even if CDC does not cover all of your child care costs, the amount that it does pay can be very helpful to your monthly budget.
What is the income limit for child care assistance in Michigan?
Eligibility for Low- or No-Cost Child Care Family of 2 making less than: $39,432 annually, or $18.96/hour full-time. Family of 3 making less than: $49,728 annually, or $23.91/hour full-time. Family of 4 making less than: $60,000 annually, or $28.85/hour full-time.
dhs child care verification form
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What is a license exempt child care provider in Michigan?
License Exempt- Unrelated Provider must provide care in the childs home. Provider must pass a comprehensive background check that includes an FBI fingerprint. The provider is responsible for the cost of the background check. Provider must participate in an annual health and safety visit.
provider form dhs 4025
Sheet1
form of business or commercial agreements between US General Services Administration and Monarch Air Group, LLC from 1998 to present. 43892, TBD, Assignment
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