CFWB Form #

Form Name

Purpose

012

Application for Child Care Subsidy

Apply for subsidized child care

012A

Instructions for Completing Your Application for Child Care Subsidy

Step by step instructions for applying for subsidized child care

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 at least 20 hours per week.

015

Referral to Employer for Income Information

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

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.

027

Housing Questionnaire

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

Forms for Child Care Subsidy Recertification (Mail completed forms to your Resource Area. These were mailed to you prior to your recertification date):

020

Income from Employment and Other Sources

Household income update for child care subsidy recertification

021

Household Information for Child Care Recertification

Verify household information for child care subsidy recertification

022

Documentation Required for Child Care Eligibility

List of documents needed for child care subsidy recertification

024

Recertfication Signature Page

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

025

Child Care Services for Eligible Families

Child Care options for families determined eligible for subsidized child care, including families whose Transitional Child Care (TCC) benefit is ending