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Report Changes to Child Care

In addition to completing an annual re-certification of benefits, recipients of child care assistance are responsible to report the following changes within 10 days of the change:

·         Address change

·         Change in employment (losing or gaining employment, change in employers, increase or decrease in hours or rate of pay)

·         Change in number of people living in the home

·         Change in child care center or provider* Needs to be reported prior to change or within the service week of change. 

·         Changes in school attendance/enrollment status

Please provide as much information as possible so we may process your reported change quickly & accurately:

Name:
Email:
Date of Birth:
Case Number:
Please provide detailed explanation of change:
Please provide us with your telephone number so we may contact you for further information:
In addition to my Child Care Worker, please forward this information to my: