Child Care Subsidy Forms for Parents
Note: All forms are in PDF format.
Form # |
Form Name |
Purpose |
CFWB 001 | Special Needs Payment Rate Application | Use this form if you are a Parent or Guardian who currently receives an ACS voucher and you are interested in requesting a Special Needs payment rate. |
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. |
|
CFWB-005 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français | ||
Referral of Suspected Childcare Subsidy Fraud |
Use this form to report child care subsidy fraud in NYC. |
|
CFWB-009 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français | ||
Voucher Wait List Request Form |
Form to be completed by families requesting to be added to the child care subsidy wait list. |
|
CFWB-010 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français | ||
CFWB-012, 012A, 012B (Spanish) |
Child Care Assistance Application Package |
Apply for child care assistance. Package includes:
|
Paquete de solicitud de asistencia para el cuidado infantil |
Solicite ayuda para el cuidado de niños. El paquete incluye:
|
|
Referral to Employer for Income Information |
Use this form to verify your income if pay stubs are not available. |
|
(Español) Remisión al Empleador para Información de Ingresos |
Use este formulario para verificar sus ingresos si los recibos de sueldo no están disponibles. |
|
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-026 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français | ||
Housing Questionnaire |
Use this form if your reason for care is temporary housing. |
|
CFWB-027 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français | ||
Forms for Child Care Subsidy Recertification (Mail completed forms to your Resource Area. These were mailed to you prior to your recertification date): |
||
Income from Employment and Other Sources |
Household income update for child care subsidy recertification |
|
CFWB-020 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français | ||
Household Information for Child Care Recertification |
Verify household information for child care subsidy recertification |
|
Documentation Required for Child Care Eligibility |
List of documents needed for child care subsidy recertification |
|
CFWB-022 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français | ||
Recertfication Signature Page |
Sign and submit this form to certify family's eligibility for continued receipt of child care subsidy |
|
CFWB-024 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français | ||
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 |
|
Attestation during COVID-19 Public Health for Application |
(Please complete this form if your documentation required for application cannot be completed due to the COVID-19 public health emergency.) |
|
CFWB-045 Translations: العربية | বাংলা | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français | ||
Declaraciones juradas durante la Emergencia de Salud Pública de COVID-19 |
(Por favor, complete este formulario si la documentación que requiere para la solicitud no se puede completar debido a la emergencia de salud pública de COVID-19). |
|
Attestation during COVID-19 Public Health for Recertification |
(Please complete this form if your documentation required for recertification cannot be completed due to the COVID-19 public health emergency.) |
|
Declaraciones juradas durante la Emergencia de Salud Pública de COVID-19 |
(Por favor, complete este formulario si la documentación que requiere para la recertificación no se puede completar debido a la emergencia de salud pública de COVID-19). |
|
Request for School-Age Care During the School Day |
For a parent to request child care assistance if their child attends a child care program when not required to be physically present in school as part of the regular school day due to COVID-19. |
Get involved in the lives of children in your community. Volunteer as a tutor, mentor, or coach.
Get involved in the lives of children in your community. Volunteer as a tutor, mentor, or coach.
Get involved in the lives of children in your community. Volunteer as a tutor, mentor, or coach.