Get In Form 28808 2008

Filling out the IN Form 28808, a Claim for Support of Children, is an essential process for vendors seeking reimbursement from Family and Children Funds. This guide provides a comprehensive and user-friendly approach to help users navigate the online form efficiently.

Follow the steps to successfully complete the IN Form 28808 online.

1. Click the ‘Get Form’ button to access the form and open it in the online editor.
2. In Section 1, enter the vendor name, which is the legal name of the benefit or product provider.
3. In Section 2, input the Tax Identification Number associated with the vendor name from Section 1.
4. In Section 3, provide an invoice number, which should be a unique identifier assigned by the provider for internal record management. Leave this blank if no invoice number is available.
5. Fill out Section 4 with the address where payments should be sent, ensuring it matches the W-9 or DD form on file.
6. Indicate the current page number and total number of pages in Section 5.
7. In Section 6, define the billing period by entering the start and end dates of the month for which you are claiming reimbursement.
8. In Section 7, calculate and enter the total amount of the claim, which is the cumulative sum from the total cost calculations in the claim.
9. Complete Section 8 by entering the Resource ID assigned by the Department of Child Services for the provider.
10. Provide the Person ID in Section 9, which is the identification number for the child receiving the services.
11. Input the case number in Section 10, assigned by the Department of Child Services.
12. Fill out Section 11 with the full name of the child for whom support is being claimed.
13. Leave Section 12 blank if you are not a contracted provider, as the PO number is not required at this time.
14. In Section 13, enter the billing code, which is '20000', representing the benefit or product provided.
15. Detail the begin date of service in Section 14, which is the date the service began.
16. Specify the end date of service in Section 15, noted as the last day the service was provided or the end date of the billing period if still ongoing.
17. Document the unit of service rendered in Section 16, indicating how many times the service was provided.
18. Enter the rate for the service in Section 17, which reflects the cost per unit of service.
19. Calculate the total cost in Section 18 by multiplying the unit by the rate.
20. In Section 19, the vendor or authorized agent must provide their signature to certify the claim.
21. Input the vendor email address in Section 20 to facilitate communication regarding the claim.
22. Finally, in Section 21, enter the date of authorization for the claim, ensuring the form is completed and dated to enable payment.
23. At the end of the process, users can save their changes, download, print, or share the completed IN Form 28808.

Complete your documents online now and ensure timely filing of your claims.