Edit, Download, and Sign the Provider Cost Verification Form - ChildCare Aware of America

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How do I fill this out?

To fill out the Provider Cost Verification Form, ensure you verify the provider's eligibility, have the child care provider complete the form, and make sure it is signed by both the provider and guardian. Submit the form along with the family application. Ensure all information is accurate to avoid any issues.

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How to fill out the Provider Cost Verification Form - ChildCare Aware of America?

  1. 1

    Verify the provider's eligibility before filling out the form.

  2. 2

    Have the child care provider complete the form with accurate rate details.

  3. 3

    Ensure the form is signed by both the provider and the guardian.

  4. 4

    Submit the form along with the family application.

  5. 5

    Check that all information provided is consistent and accurate.

Who needs the Provider Cost Verification Form - ChildCare Aware of America?

  1. 1

    Parents seeking fee assistance for child care need this form to provide rate information.

  2. 2

    Child care providers need this form to participate in fee assistance programs.

  3. 3

    Families applying for military child care fee assistance programs require this form.

  4. 4

    Guardians verifying child care rates and discounts need this form.

  5. 5

    Specialists processing fee assistance applications need accurate information from this form.

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Editing this PDF on PrintFriendly is simple with our intuitive editor. You can easily update rate details and other information on the form. Save your changes directly within the PDF editor.

  1. 1

    Open the Provider Cost Verification Form on PrintFriendly.

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    Click 'Edit' to enable editing mode.

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What are the instructions for submitting this form?

Submit the Provider Cost Verification Form along with the family application to ChildCare Aware of America. You can email the form to feeassist@childcareaware.org, fax it to 1-866-662-2246, or mail it to ChildCare Aware of America, 1515 N Courthouse Rd, 3rd Floor, Arlington, VA 22201. Ensure all information is accurate and complete before submission. My advice is to double-check all details to avoid any delays or issues with the application process.

What are the important dates for this form in 2024 and 2025?

Important dates for this form in 2024 and 2025 will be determined based on the fee assistance program's requirements. Ensure timely submission to avoid delays.

importantDates

What is the purpose of this form?

The Provider Cost Verification Form is essential for processing fee assistance applications for child care services. It collects information about child care rates, discounts, and the schedule of care to ensure accurate processing. By submitting this form, families can determine their eligibility for fee assistance and avoid overpayments.

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Tell me about this form and its components and fields line-by-line.

The form contains various fields to capture essential information about the child care provider and the rates.
fields
  • 1. Child Care Facility Name: The name of the child care facility providing care.
  • 2. Provider ID#: A unique identifier for the child care provider.
  • 3. Child Care Director/Point of Contact: The name of the individual responsible for the child care facility.
  • 4. Provider Address: The address where child care is provided.
  • 5. City: The city where the child care facility is located.
  • 6. State: The state where the child care facility is located.
  • 7. Zip Code: The postal code for the child care facility's location.
  • 8. Provider Phone Number: The contact phone number for the child care provider.
  • 9. Sponsor Name: The name of the individual sponsoring the child's care.
  • 10. Family ID#: A unique identifier for the family seeking fee assistance.
  • 11. Rate Information: Details about the child's name, days of care, hours of care, and rates before and after discounts.
  • 12. State Subsidy Received: Indicates if a state subsidy is received and includes the voucher if applicable.
  • 13. Rate Frequency: The frequency of the rate, such as weekly, monthly, or annually.
  • 14. Effective Date: The start date for the provided rate information.
  • 15. Start of Care Date: The date when the child's care begins.
  • 16. Annual Registration Fee: The annual registration fee for the child care facility.
  • 17. One Time Registration Fee: A one-time registration fee for the child care facility.
  • 18. Discounts: Description of any discounts given.
  • 19. Rate Changes within the Next 12 Months: Information about any rate changes expected within the next 12 months.
  • 20. I certify that all above information is correct: Certification statement indicating the information provided is accurate.
  • 21. Signatures: Signatures from the child care director and the parent/guardian.

What happens if I fail to submit this form?

Failure to submit the Provider Cost Verification Form may result in ineligibility for fee assistance and potential overpayments.

  • Ineligibility for Fee Assistance: Families may not qualify for fee assistance if the form is not submitted.
  • Potential Overpayments: Accurate fee calculations may not be possible, leading to overpayments.

How do I know when to use this form?

Use this form when applying for child care fee assistance to ensure accurate rate reporting.
fields
  • 1. Applying for Fee Assistance: Submit this form when applying for child care fee assistance.
  • 2. Verifying Child Care Rates: Use this form to report accurate child care rates and discounts.

Frequently Asked Questions

How do I fill out the Provider Cost Verification Form?

Verify provider eligibility, have the provider complete the form, ensure signatures, and submit with the family application.

Can I edit the form on PrintFriendly?

Yes, you can easily edit the form using PrintFriendly's PDF editor.

How do I sign the form on PrintFriendly?

Use PrintFriendly's signature feature to add your signature to the form.

Can I share the form through PrintFriendly?

Yes, you can share the form via email or download using PrintFriendly's sharing options.

What information do I need to provide on the form?

Provide child care rates, discounts, rate changes, schedule of care, and signatures from both provider and guardian.

How often should rate changes be reported?

All rate changes, including classroom and age changes, should be included on the form.

What if the provider does not know the exact date of a rate change?

The provider should provide their best estimate and indicate it on the form.

Are registration fees covered under the fee assistance programs?

Currently, registration fees are not covered under the Navy, Air Force, Marine Corps, or NGA fee assistance programs.

What happens if I fail to correctly report tuition information?

Failure to accurately report information may result in removal from the fee assistance program and potential repayment of overpaid amounts.

How is the monthly fee determined for fee assistance?

The monthly fee is calculated based on the facility's rates and the DoD parent fee, with conversions handled by CCAoA if necessary.

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