Get Child Care Employment Verification - The Office Of Public Assistance

Filling out the Child Care Employment Verification form is an important step in confirming your employment for child care services. This guide provides clear, step-by-step instructions to help you navigate the online process effectively.

Follow the steps to complete the employment verification form

1. Click ‘Get Form’ button to access the Child Care Employment Verification form and open it for editing.
2. In Section A, provide the employer's information. Fill in the company name, address, city/state/zip, phone number, and fax number accurately.
3. Proceed to Section B for employee information. Include the employee's name, Social Security number (SSN), date of hire or return date, and indicate if they are still employed by circling 'Yes' or 'No'. If 'No', enter the last date of employment.
4. Indicate whether pay stubs have been given by circling 'Yes' or 'No'. Specify the pay frequency (weekly, bi-weekly, monthly, semi-monthly) and denote if the employee works overtime and the regular hourly pay rate.
5. If applicable, circle 'Yes' or 'No' for tips received and note the weekly amount if 'Yes'. Fill in the number of overtime hours worked weekly and the overtime hourly rate.
6. Document the gross income for the last four consecutive pay periods by entering the pay dates and respective income amounts.
7. In Section C, provide the scheduled hours of work. Complete the days and times as required, ensuring to detail the earliest start time and latest end time.
8. Section D requires the employer's signature, which confirms that the provided information is accurate. Include the name and position of the individual signing.
9. In Section E, the employee must provide their signature to authorize the release of the information to the Clermont County Department of Job and Family Services (CCDJFS). Include the date of the signature.
10. Review all sections to ensure accuracy, then save your changes. You can download, print, or share the completed form.

Complete your employment verification form online today to ensure timely processing.