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- Begin by entering your Case Number and Program/Provider Number at the top of the form. Ensure these details are accurate for proper processing.
- In the Household Information section, fill in your name, telephone number, and address. If any information has changed, indicate this clearly in the provided lines.
- Answer whether your household is a two-parent/caretaker household and select the reason for child care from the options provided.
- For each household member, check their marital and military status using the codes provided. If there are changes, be sure to mark them accordingly.
- Add any new children or household members by filling out their details in the designated area. Remember to attach copies of birth certificates for new children.
- Finally, review all entries for accuracy before saving or printing your completed form.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2017 | 1 Satisfied (14157 Votes) |
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