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  • Mt Dphhs-hcs/cc-015 2011

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CCR&R ELIGIBILITY SPECIALIST STAFF ONLY CASE / CASE EVENT NUMBER Best Beginnings Child Care Scholarship Program HEAD OF HOUSEHOLD NAME CHILD CARE SERVICE PLAN ELIGIBILITY BEGIN DATE ELIGIBILITY END DATE ELIGIBILITY DETERMINATION DATE R&R DATE STAMP CASE EVENT WORKER NAME INSTRUCTIONS When you select a child care provider, the Child Care Resource and Referral (CCR&R) agency needs the information below to complete the child care certification plan. Use a separate form for each.

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How to fill out the MT DPHHS-HCS/CC-015 online

This guide provides clear and concise instructions on completing the MT DPHHS-HCS/CC-015 form online. Whether you are seeking assistance for child care or have questions about the process, this resource is here to support you.

Follow the steps to successfully complete the MT DPHHS-HCS/CC-015 form.

  1. Click ‘Get Form’ button to access the MT DPHHS-HCS/CC-015 form and open it in your browser.
  2. Begin by entering the head of household name in the designated field. This is the individual responsible for completing the form.
  3. Fill in the contact information, including the phone number and address of the applicant.
  4. Provide the necessary details about the child care provider. You must include the provider's name, license number, address, and telephone number.
  5. Indicate whether the child is related to the provider. If yes, specify the relationship.
  6. Complete the hours and days child care is provided section, specifying start and end times for each day of the week, and note if the schedule remains consistent or varies.
  7. Review all entered information for accuracy. Make sure any necessary documentation is ready to support your application.
  8. Once satisfied with the information provided, save your changes, and choose to download, print, or share the form as needed.

Complete your MT DPHHS-HCS/CC-015 form online today for an efficient application process.

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Income Requirements Family SizeAnnual Income Limit*Monthly Income Limit 1 $51,610 $4,300 2 $67,490 $5,624 3 $83,370 $6,947 4 $99,250 $8,2702 more rows

For more information about the Best Beginnings Child Care Scholarship, or to apply for the program, contact one of our Eligibility Specialists at 406-756-1414 or 800-204-0644 or click the link below.

Families residing in Washington state may be eligible for Child Care Subsidy if their income is at or below 60% of the state Median Income (SMI) at application or 65% of SMI when reapplying. For a family of two, that is $3,641 per month, for a family of three $4,498, and for a family of four $5,354.

Ratio and group size requirements AgeStaff-to-child ratioMaximum group size Newborn to 23 months old 1:4 12 children Two to three years old 1:8 16 children Four years old 1:10 24 children Five years old and older 1:14 32 children Sep 8, 2023

As of August 2019, the income limit to qualify for assistance was increased to $31,992 (150 percent of poverty), and the exit eligibility limit was increased to $39,456 (185 percent of poverty), to adjust for the 2019 federal poverty level. 2 Children receiving protective services are exempt from copayments.

Family income must be less than 47% State Median Income (SMI) at time of initial application to qualify for funds. Examples of income before taxes (effective October 2, 2023): Family of 2 – Earn less than $40,156 a year. Family of 3 – Earn less than $49,605 a year.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232