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Reports, Forms, Pamphlets and Policies
You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
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| Download | Number | Name |
Effective Date |
|---|---|---|---|
|
CCA-1105A-S | Declaración de reclamante fiscal | 11/01/2021 |
|
CCA-0024A-S | Declaración de Verificación de Sueldo y Empleo | 11/01/2021 |
|
CCA-0225A | Verification of Unable\Unavailable Status | 11/01/2021 |
|
CCA-1186A | Authority to Release Information | 11/01/2021 |
|
CCA-0044A | Verification of Shelter Case Plan | 11/01/2021 |
|
CCA-0024A | Employment and Wage Verification Statement | 11/01/2021 |
|
CCA-1235A | CCA Change Report | 11/01/2021 |
|
CCA-1105A | Tax Claimant Declaration | 11/01/2021 |
|
CCA-1235A-S | CCA Informe de Cambios | 11/01/2021 |
|
CSE-1299A-S | Guía de Recursos para el Cliente de la DCSS | 12/01/2021 |
| Download | Number | Name | Effective Date |
|---|---|---|---|
|
CCA-1140A-S | Inscripción de Depósito Directo para Centros y Hogares Comunitarios | 09/01/2022 |
|
CCA-0048A | Non-Certified Relative Provider Billing Report | 10/01/2022 |
|
CCA-0048A-S | Informe de Facturación de Proveedores Parientes no Certificados | 10/01/2022 |
|
CCA-1021A | Unpaid Co-payment Worksheet | 10/01/2022 |
|
CCA-1021A-S | Informe de Copagos Atrasados | 10/01/2022 |
|
CCA-0001A | Application for Child Care Assistance | 10/01/2022 |
|
CCA-0001A-S | Solicitud de Asistencia para Cuidado Infantil | 10/01/2022 |
|
CCA-1224A | Fast Pass DCS Referral | 10/01/2022 |
|
CCA-0208A-S | Acuerdo del Proveedor/Padre/Madre/Guardian - Acerca de los Costos de Cuidado de Niños | 11/01/2022 |
|
CCA-0229A_FY23 | Child Care Assistance Gross Monthly Income Eligibility Chart And Fee Schedule FY 2023 (English/Spanish) | 11/01/2022 |
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