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IN CCDF Discrepancy Childcare Statement Services Form 2005-2025 free printable template

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Revised CCDF Discrepancy Childcare Statement of Services Form 7/1/2005 Weeks of Service through. Beginning Ending Provider EIN/SSN Childcare Provider Name Parent/Guardian Name City State Zip Childcare Director s Name Provider Phone Number Parent Phone Number Provider County Location Child s Name One Child Per Form Description of Discrepancy Week 1 Day Date Card Issues Code Sunday Monday Tuesday Wednesday Thursday Friday Saturday Totals Time IN a.m. p.m. Number of Days Week 2 POS Not Installed...
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How to fill out IN CCDF Discrepancy Childcare Statement Services Form

01
Obtain the IN CCDF Discrepancy Childcare Statement Services Form from the appropriate agency or website.
02
Read the instructions carefully to understand the requirements for filling out the form.
03
Provide your personal information at the top of the form, including name, address, and contact details.
04
Specify the childcare provider’s information, including name, address, and type of services provided.
05
Detail the discrepancies you are reporting in the appropriate section, including dates, amounts, and specific issues.
06
Attach any relevant documentation that supports your claims of discrepancy, such as receipts or previous statements.
07
Review the filled-out form to ensure accuracy and completeness.
08
Sign and date the form before submission.

Who needs IN CCDF Discrepancy Childcare Statement Services Form?

01
Parents or guardians receiving childcare assistance who notice discrepancies in their payment or service statements.
02
Childcare providers seeking to address discrepancies reported by clients.
03
Agencies or organizations involved in the administration of childcare funding or services.
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Child Care and Development Fund (CCDF) Program.
If you need help locating a CCDF-eligible provider, contact your local Child Care Resource and Referral agency. Families must then have their provider fill out the provider information form. Grant opportunities are now available for the School Age Child Care program.
The Child Care and Development Fund is a federal program that helps low-income families obtain child care so that they may work, attend training or continue their education. The purpose of CCDF is to increase the availability, affordability and quality of child care.
$250 weekly facility rate - $221 child care subsidy = $29 weekly overage.
To qualify for CCDF in Indiana, a family's gross monthly income before taxes and any other deductions can't exceed 127% of the federal poverty level. The family can then remain on the program until its income exceeds 185% max of the Indiana median income guidelines by family size, which is determined by the state.
The CCDF program is administered through the Indiana Family and Social Services Administration in the Office of Early Childhood and Out-of-School Learning. To apply for the CCDF voucher program, you must contact your local intake agent. Please see the map below to determine the intake agent for the county you live in.
Documents to complete your Child Care and Development Fund or On My Way Pre-K Online Application Residency verification. ID verification. Service need verification. Child care provider information. Additional sources of income. Parent applicant worksheet. Attendance card agreement. On My Way Pre-K agreement.
To qualify for CCDF in Indiana, a family's gross monthly income before taxes and any other deductions can't exceed 127% of the federal poverty level. The family can then remain on the program until its income exceeds 185% max of the Indiana median income guidelines by family size, which is determined by the state.

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The IN CCDF Discrepancy Childcare Statement Services Form is a document used to report discrepancies related to childcare services provided under the Child Care Development Fund (CCDF) in Indiana.
Providers and recipients of childcare services who notice discrepancies in their CCDF billing or services received are required to file this form.
To fill out the form, you need to provide detailed information regarding the discrepancy, including dates, amounts, and the nature of the inconsistencies, and submit it to the appropriate authority.
The purpose of the form is to identify and correct discrepancies in childcare service billing, ensuring accurate processing for CCDF reimbursements.
The form must report relevant details such as the child's name, service dates, billing amounts, descriptions of the discrepancies, and contact information for follow-up.
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