Get Child Care Assistance Program Change Form Dhs-4794-eng.pdf - Pinetech

Filling out the Child Care Assistance Program Change Form DHS-4794-ENG is an essential step in reporting changes that may affect your eligibility or benefits. This guide provides clear and supportive instructions to help users navigate the form efficiently and accurately.

Follow the steps to complete your form with ease:

1. Press the ‘Get Form’ button to obtain the form and open it in the editor for online completion.
2. Provide your personal information. Fill in your name, case number, address, city, state, zip code, worker's name, and contact details.
3. Indicate the purpose for the form. Check the box if you are reporting a change within 10 days. If you need more space, add a separate sheet.
4. Report any change in your address. Provide details of the new address, including the county you moved to and from, and the date of the move.
5. List any changes in the people residing in your home. Provide their names, relationships to you, social security numbers, birthdates, and check the relevant boxes indicating if they moved in or out.
6. Indicate if any new adult family members need help with child care costs and if there are any new children who need child care.
7. If there are changes in child care arrangements, specify your new child care hours needed and reasons for change, as well as any new child care provider details.
8. Report any changes in income. Include information about any new jobs or changes in pay and employment hours for family members.
9. Include documents to support your reported changes, such as pay stubs or award letters when applicable.
10. Complete the acknowledgment section by signing and dating the form. Verify with your phone number.
11. Finally, save your changes, download, print, or share the completed form as necessary.

Take the next step and complete your Child Care Assistance Program Change Form online today.