Get Ece Cc 10a Form

Filling out the Ece Cc 10a Form online can streamline the process of requesting payment for child care services. This guide provides clear, step-by-step instructions to help you navigate each component of the form effectively.

Follow the steps to complete the Ece Cc 10a Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the provider's name in the designated fields, including last and first names.
3. Fill in the mailing address including street or P.O. Box, city, state, and zip code.
4. Indicate the month being billed for by providing the first and last days of the month.
5. List each child's name for line a, along with their birth date and care fees.
6. Document the date started for any new children and the date a child left care if applicable.
7. Provide the parent's name for line b.
8. Record the number of days for part days (0-2 hours, 2-4 hours) and full days (4 or more hours).
9. Note the number of days that were non-traditional.
10. Review the form for accuracy, then provide the provider signature and the date submitted.
11. Calculate the total amount requested for payment and complete any agency use only sections.
12. After completing the form, you can save changes, download, print, or share the form as needed.

Complete your documents online today for a more efficient filing process.