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DEPARTMENT OF CHILDREN AND FAMILIES DCFF2978E (R. 06/2016) STATE OF WISCONSIN Wis. Stat. 48.685 Wis. Admin. Code DCF 12.03 BACKGROUND INFORMATION DISCLOSURE (BID) Completion of this form is required.

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Follow the steps to complete the Dcf F 2978 E form.

  1. Click ‘Get Form’ button to access the form and display it in the editor.
  2. Begin by selecting the appropriate checkbox that describes your status, such as current or prospective employee, applicant for a license or certification, or another relevant category.
  3. Complete the personal information section, which includes your first and middle name, last name, birth date, race, social security number (optional), home address, city, state, and zip code.
  4. Provide the name and address of your potential employer, licensing agency, certifying agency, or child care center.
  5. Move to Section A, where you will answer questions regarding criminal history. Respond to each question by selecting 'Yes' or 'No' and provide detailed explanations as required.
  6. If applicable, indicate any licenses, certifications, or registrations that have been limited, denied, or revoked in Section B. Provide thorough explanations for each 'Yes' answer.
  7. Ensure that all fields are filled out accurately. Review your answers carefully to avoid any mistakes.
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The Wisconsin Department of Children and Families (DCF) is an agency of the Wisconsin state government responsible for providing services to assist children and families and to oversee county offices handling those services.

What happens when I make the report? Your report will be taken by a social worker who will ask the names and ages of the children in the home and their address. The social worker will also ask the names of the parents or anyone else who resides in the home.

You will provide your child care provider's name and address, your approved activity schedule, and the times that your child will need child care to your local agency worker. This information will be used to create your authorization. Call 1.888. 947.6583: Select option one (1) for Child Care.

Telephone - You may call the FIS customer service line (1.877. 201.7601) and pay over the phone. It is important to have your card number with you before making the call.

Call us at 1.888. 947.6583. Listen to the prompts to request a child care authorization.

PACS helpline: (800) 943-9499. PACS Assistance Mailbox: dwspacu@wisconsin.gov.

"Neglect" is the failure or refusal from the parent or caregiver to provide necessary care or meet a child's basic and/or emotional needs. Neglect can also occur when a parent or caregiver fails to protect a child from harm or puts the child in the care of someone else who may harm them.

The MyWIChildCare card is loaded with a monthly amount for child care expenses based on your authorizations. The subsidy is intended to be used the month it is put on the card. Unspent funds will carry over into the next month, but any funds not spent within 90 days will drop off from the card.

The child must be 12 or under (up to 19 for a child with special needs) and: ▪ A Resident of Wisconsin ▪ A U.S. Citizen or qualified immigrant. Families with a gross income (before taxes) at or below 185% of the federal poverty level (FPL) may be eligible.

Secretary Emilie Amundson Secretary Amundson received her undergraduate degree from UW-Madison, her Master of Education Policy from Harvard Graduate School of Education and has completed coursework toward a Ph.

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