Get Child Care Payment

Filling out the Child Care Payment Inquiry Form online can streamline the process of addressing delayed payments for child care services. This guide will walk you through each section of the form with clear and supportive instructions to ensure you complete it accurately.

Follow the steps to complete the Child Care Payment form online.

1. Click the ‘Get Form’ button to access the Child Care Payment Inquiry Form and open it in your editing software.
2. Fill in the date at the top of the form. Make sure to enter today's date.
3. Provide the parent’s name in the designated field, ensuring it is clear and spelled correctly.
4. List the names of your child or children in the respective space provided.
5. Indicate the start date of child care services in the appropriate section.
6. Enter your PA case number in the designated field.
7. Fill in your ACCIS case number, if applicable, in the following field.
8. Provide a daytime telephone number where you can be reached.
9. If you have additional children to include, attach a separate page with their information.
10. In the Provider/Program Information section, enter the provider/program ID number.
11. Fill in the name of the child care provider or program.
12. Provide the daytime telephone number of the provider.
13. Include the provider’s address in the section provided.
14. If there are any other complaints, detail them in the specified area.
15. Document previous requests by indicating if you have called the child care hotline or spoken with staff, including dates and results.
16. Once all fields are completed, review the form for accuracy, then save your changes, download, print, or share the completed form as needed.

Take action now by filling out the Child Care Payment Inquiry Form online to resolve your payment issues promptly.