Form #

Form Name

Purpose

Application for child care assistance. Package includes:

• Application (CFWB-012)
• Instructions (CFWB-012A)
• Submission Checklist (CFWB-012B)
• Immigration Memo
• Voter Registration Form

Solicite ayuda para el cuidado de niños. El paquete incluye:

• Página de portada
• Aplicación (CFWB-012)
• Instrucciones (CFWB-012A)
• Lista de verificación de presentación (CFWB-012B)
• Formulario de registro de votantes

CFWB-005

Vocational, Education and Training Verification

Submit this form if your reason for care is school or vocational training attendance. This form documents your attendance at an approved education or training program.

CFWB-015

Referral to Employer for Income Information

Use this form to verify your income if pay stubs are not available.

CFWB-015 (Español)

(Español) Remisión al Empleador para Información de Ingresos

Use este formulario para verificar sus ingresos si los recibos de sueldo no están disponibles.

CFWB-026

Work Search Record

Use this form if your reason for care is looking for work if you do not have a current benefits rate letter from New York State Unemployment Benefits.

CFWB-027

Housing Questionnaire

Use this form if your reason for care is temporary housing.

CFWB-058

Caretaker Attestation

For use by legal guardian, caretaker relative or other person who lives with the child.

CFWB-022

Documentation Required for Child Care Eligibility

List of documents needed for child care subsidy recertification

CFWB-020

Income from Employment and Other Sources

Household income update for child care subsidy recertification

CFWB-021, CFWB-021 (Español)

Household Information for Child Care Recertification

Verify household information for child care subsidy recertification

CFWB-024

Recertfication Signature Page

Sign and submit this form to certify family's eligibility for continued receipt of child care subsidy

CFWB-009

Referral of Suspected Childcare Subsidy Fraud

Use this form to report child care subsidy fraud in NYC.

N/A

Early Care & Education Programs for Families Experiencing Homelessness

For information on all early care and education services available for families in shelter or temporary housing.