Dhs 4025 form 2013-2019-2026

1. Click ‘Get Form’ to open the dhs 4025 form in the editor.
2. 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.
3. 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.
4. Complete the 'Child Development and Care Provider Verification' section. Fill in your name, address, provider ID number, and contact details accurately.
5. List all children under your care in the designated area. Include their names, dates of birth, and indicate if you are related to them.
6. Both parent and provider must read and certify agreement to statements on page 2. Ensure signatures and dates are included before submission.
7. Once completed, return the form to your local DHS office specialist for processing.

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