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Description
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Pages
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OCFS-6025 Application for Child Care
OCFS-6025-S Spanish Version
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This application may be used if your family is ONLY applying for child care services. If your family is applying for public assistance or other benefits including child care services, you MUST use the Statewide Common Application (LDSS-2921), which can be found in the State Forms section below.
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2
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OCFS-6026 Instructions
OCFS-6026-S Spanish Version
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How to complete the OCFS-6025 Application for Child Care Assistance
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4
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CCB-6010-018 Documentation Required for Child Care Eligibility
CCB-6010-018 Spanish Version
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List of the types of documentation you can submit as proof of identity, address, legal residence in U.S., income, etc.
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2
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CCB-6010-002 Verification of Residence
CCB-6010-002 Spanish Version
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Have your landlord or other professional person who knows you and your family complete this form verifying your residency and household composition.
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1
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CCB-6010-003 Absent Parent Information Form
CCB-6010-003 Spanish Version
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Only complete this form if the parent(s) of any child(ren) in need of child care is(are) NOT in the household. Fill out a separate section for EACH parent that is absent from the household. Attach additional pages if needed.
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2
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CCB-6010-004 Confidential Inquiry on Employment
CCB-6010-004 Spanish Version
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Each parent who is working must have their employer complete this form (OR submit a written statement) verifying the days & hours usually worked and wages earned. If you are working more than one job, a separate form (or written statement) must be completed for each job. Twelve (12) weeks of pay stubs must also be submitted.
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1
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CCB-6010-005 Self-Employment Worksheet
CCB-6010-005 Spanish Version
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Submit this form if you are self-employed. You must also submit the required supporting documentation (see reverse side of the Self-Employment Worksheet).
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2
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CCB-6010-006 School/Vocational Training Verification Form
CCB-6010-006 Spanish Version
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If your reason for needing child care is school or Vocational training attendance, have the school/program complete this form documenting your attendance.
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1
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CCB-6010-007 Child Care Provider Information Sheet
CCB-6010-007 Spanish Version
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Use this form to identify the child(ren) in need of a child care subsidy, what days/hours child care is needed, and whether the child(ren) is(are) already in child care or you need to locate a child care provider for your child(ren).
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1
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CCB-6010-009 Client Responsibility Notice
CCB-6010-009 Spanish Version
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You are required to read, sign and return this notice acknowledging your responsibility to immediately report to DSS any changes to your employment, income, housing, household composition, child care provider, etc.
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1
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CCB-6010-010 Medical Statement in Support of Special Needs Consideration & Definition of Child with Special Needs in Need of Child Care
CCB-6010-010 Spanish Version
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Have a qualified professional complete this form for each child in need of a child care subsidy who has a diagnosed special need that adversely affects the child's ability to function normally. Refer to the "Definition of Child with Special Needs in Need of Child Care" that is attached to the form.
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3
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CCB-6010-016 Employer Statement
CCB-6010-016 Spanish Version
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Employee Earnings Paid in Cash form for Employer.
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1
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CCB-6010-019 Special Needs Rate Application
CCB-6010-019 Spanish Version
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Application for additional funding for a special needs child.
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3
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