WebJan 5, 2001 · Attendance Exemption Request form: IL444-4338 (pdf) If approved, the requested eligible days will be paid. If denied, the payment will be based on attended days only. NOTE: Providers who report monthly attendance of 70% or more may be eligible for payment based on 100% of eligible days as stated in CCAP Policy Section 06.03.01 - … WebComplete the application, child care request, work schedule and absent parent form (if applicable) and send it to: Department of Human Services. 111 Westfall Rd. Rochester, …

Monroe County, NY - Child Care Assistance Program

WebDHS 9800 A2D (7/1/2007) **Parent signature is required as disclosed in the 9800 agreement for payment of vouchers. Web4. If I am not able to use form 470-4534 or 470-4535, I must keep adequate attendance records instead. To be considered adequate, attendance records must include the child’s name, the dates and daily time in and time out entries for days the child was in care, and the signature of the parent or other adult designee r.c. 102.02 a 2 h

Oregon DHS: Finding DHS forms

WebJul 1, 2007 · Download Printable Form Dhs9800 A2d In Pdf - The Latest Version Applicable For 2024. Fill Out The Daily Child Attendance Form … WebA number of forms are available in languages other than English, as well as in large print. How to locate a specific form. Our Forms search page offers many options for finding current and past DHS forms. When using the search page: In the form number (Form #) field, use only numbers. Do not include any letters in this field. WebFeb 6, 2001 · See WAG 09-03-01-e when referring a person to IDVA to apply for Aid and Attendance. When you need the applicant's written consent for release of information, use Consent to Release of Information (Form 34) if there is no release statement on the request form. Use Authorization to Release Medical Records (Form 4701H) to get medical … rc1015 cannot open include file