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Gov Fax 631 854-3331 If you have questions call 631 854-3349 P. O. BOX 18100 HAUPPAUGE NY 11788-8900 CCB-6010-002 Revised 9/2016 www. I understand that if I intentionally falsified information on this form or if I assisted the applicant in falsifying any information I may be prosecuted under State law. DO NOT FILL FORM OUT YOURSELF. DO NOT LET A FAMILY MEMBER OR A NOTARY FILL FORM OUT. Applicant / Recipient Name Case if applicable I do hereby state that the above named individual print name...
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How to fill out child care benefit re-determination

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How to fill out child care benefit re-determination

01
Gather all the necessary documents related to your child's care, such as receipts, invoices, and any other relevant proof of expenses.
02
Access the official website of the organization or agency providing the child care benefit re-determination form.
03
Download and print the child care benefit re-determination form.
04
Carefully read and understand the instructions mentioned in the form.
05
Provide your personal and contact details, including your name, address, and phone number.
06
Fill in all the required information about your child, such as their name, date of birth, and Social Security number.
07
Provide detailed information about the child care provider, including their name, address, and contact information.
08
Document the amount and frequency of child care expenses you have incurred.
09
Attach all the supporting documents as mentioned in the instructions, such as receipts or invoices.
10
Review the completed form to ensure all the information provided is accurate and complete.
11
Sign and date the form.
12
Submit the filled-out form and all supporting documents to the designated address or office mentioned in the instructions.
13
Keep a copy of the completed form and all supporting documents for your records.

Who needs child care benefit re-determination?

01
Parents or legal guardians who are currently receiving child care benefits and have experienced changes in their circumstances that may impact their eligibility or benefit amount.
02
Anyone who wants to ensure they are receiving the correct amount of child care benefits based on their updated situation.
03
Individuals who have recently started or stopped using child care services and need to adjust their benefit amount accordingly.
04
Families who have experienced changes in income, employment status, or child care provider information.
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Child care benefit re-determination is a process where the recipient of child care benefits must update their information and re-evaluate their eligibility for the benefit.
Anyone who is currently receiving child care benefits is required to file for re-determination.
To fill out child care benefit re-determination, the recipient must provide updated information on their income, expenses, and any changes in their family situation.
The purpose of child care benefit re-determination is to ensure that recipients are receiving the correct amount of benefits based on their current circumstances.
Recipients must report changes in income, expenses, family size, and any other relevant information that may affect their eligibility for child care benefits.
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