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  • Ca Ccp 2145 - Sacramento County 2015

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Month/Year of Care Sacramento County Stage One Child Care Request for Reimbursement 2145 Form SUBMIT COMPLETE FORM TO: DHA, 2001 19th Street, Sacramento, CA 95818 or DHAChildCare2145s saccounty.net.

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How to fill out the CA CCP 2145 - Sacramento County online

Filling out the CA CCP 2145 - Sacramento County form online is a straightforward process that requires attention to detail to ensure accurate reimbursement for child care services. This guide provides comprehensive steps to assist you in completing the form correctly and efficiently.

Follow the steps to accurately complete the CA CCP 2145 form online.

  1. Press the ‘Get Form’ button to access the CA CCP 2145 form online.
  2. Start with SECTION 1 - Parent Information. Enter the name of Parent 1, the child's full name, age, date of birth, and home address. Include the parent's contact phone number and any information on the second parent if applicable.
  3. Move to SECTION 2 - Child Information. Fill in details on the child's schooling, including the school name, type of activity, and the schedule of activities.
  4. Proceed to SECTION 3 - Child Care Provider Information. Fill out the type of provider and the provider's name, contact information, and address.
  5. In SECTION 4 - Child Care Provider Billing Summary, accurately enter billing rates for services rendered. Ensure the amounts match the care used as detailed in previous sections.
  6. On the back of the form, carefully enter the daily care schedule, noting times for sign-in and sign-out for each day that care was received. Do not forget to include initials on each entry.
  7. Review all sections to ensure that the information is complete and accurate. Both the parent and provider must sign and date the front of the form.
  8. Once everything is filled out correctly, save your changes, then download, print, or share the form as needed. Ensure it is submitted promptly to avoid payment delays.

Complete your documentation online today for timely reimbursement.

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CA CCP 2145 - Sacramento County
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