Child Care Assistance Program Reimbursement Sample Claim Form

Description:

These are the necessary steps to file a Child Care Assistance Program Reimbursement Sample Claim Form:

• Please fill out and complete either monthly or any 4 weeks. Claim forms received by the 2nd of the month will be paid on the 15th. Please allow for delivery. Claim forms received after the 2nd, but on or before the 15th of the month will be paid on the last day of the month.
• Use a separate form for each child care provider.
• Your child care provider must sign this form.
• Attach a copy of your paid receipts to this form. The receipts will not be returned.