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  • Ny Cfwb-012 (cs-925) 2023

Get Ny Cfwb-012 (cs-925) 2023-2026

Formation on what documents are required. ATTENTION: This application is used to apply only for Category 2 or 3* child care assistance (for families not in receipt of cash assistance). To apply for Cash Assistance or other benefits, including Category 1 Child Care Assistance (for families in receipt of cash assistance), you must use the New York State Application for Certain Benefits and Services (LDSS-2921). Please Note: All sections of this form must be filled out to be considered complete un.

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How to fill out the NY CFWB-012 (CS-925) online

The NY CFWB-012 (CS-925) is an application for child care assistance specifically intended for families not receiving cash assistance. This guide will provide you with a clear and supportive step-by-step process for completing the form online, ensuring you submit a thorough application for potential benefits.

Follow the steps to successfully complete the NY CFWB-012 (CS-925) online.

  1. Press the ‘Get Form’ button to access the application form online.
  2. In Section 1, enter the applicant details. This includes the last name (with any aliases), first name, middle initial, home address, telephone numbers, marital status, and primary language. Ensure all fields are completed unless stated as optional.
  3. In Section 2A, list each child needing care. Include their full name, relationship to you, date of birth, gender, ethnicity, race, social security number (if applicable), and whether the child has a disability.
  4. In Section 2B, provide details of all household members who are not listed in Section 2A, including their relationship to you, date of birth, gender, and race. Mention whether they are Hispanic or Latino and include social security numbers as applicable.
  5. In Section 3, state your reason for requesting child care assistance. Options include employment, vocational training, domestic violence services, or other qualifying reasons. Also, indicate if a non-custodial parent can provide childcare.
  6. In Section 4, include employment information for the applicant as well as any second parent or caretaker in the household looking for childcare. Provide employer details, job start dates, and whether their jobs have rotating shifts or require overtime.
  7. In Section 5, outline your typical work or activity schedule, including travel times to the childcare provider. This schedule should be for each parent or caretaker involved.
  8. In Section 6, report all income sources for yourself and other eligible household members, including wages, social security benefits, and any child support payments. Ensure to document how often this income is received.
  9. In Section 7, provide the details for the child care provider(s) you intend to use, including names and addresses.
  10. Review the certification section in Section 8. Sign and date the application accurately. If applicable, both parents or caretakers need to sign.
  11. Finally, save changes to your application. You may download, print, or share the completed form as necessary before submitting.

Start your application today by completing the NY CFWB-012 (CS-925) online to secure child care assistance.

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