Families in Las Vegas seeking support for child care expenses can find a valuable resource in the Las Vegas Urban League Child Care Subsidy Program. This program, situated at 2470 N Decatur Blvd Suite 150, Las Vegas, NV 89108, offers assistance through the Child Care Enrollment Attendance Verification (EAV) Form, which plays a crucial part in the subsidy application and reimbursement process. The form requires detailed information including the provider's name and address, child and parent names, along with specific identification numbers and details about the child's attendance, such as school hours and any overnight stays. Additionally, financial aspects are addressed, asking for the provider's tax ID, and whether the client's co-payment is up to date, with space for noting any owed balances. It's important for both clients and providers to fill out the timesheet daily and ensure it's fully completed and signed by the end of each month to facilitate timely payment. The program mandates submission of these timesheets by the fifth business day of the following month; delays could result in processing during the next reimbursement cycle. Moreover, any billings, including registration or annual fees, need to be submitted within ninety days from the service month to qualify for payment approval. This careful documentation and adherence to deadlines underscore the program’s commitment to transparency and accuracy, as the information may be audited by relevant authorities to ensure the integrity of the subsidy process.
| Question | Answer |
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| Form Name | Child Care Eav Form Las Vegas |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | reimbursement, NV, timesheet, DOB |
Las Vegas Urban League |
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Child Care Subsidy Program |
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2470 N Decatur Blvd Suite 150, Las Vegas, NV 89108 |
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Bill Registration Fee |
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Child Care Enrollment Attendance Verification (EAV) Form
Provider Name: Provider Address:
Child Name:
Parent Name:
DATE
Overnight
On Track
PLEASE DO NOT USE WHITE OUT
Provider Tax ID or SSN:
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Child DOB: |
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Child UPI or SSN: |
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Child Track: |
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Child School Hours: |
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TIME IN |
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TIME OUT |
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TIME IN |
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TIME OUT |
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Parent Signature for Authorization of |
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Discretionary Day |
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Is the client's
Provider's Initials:
Yes |
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No |
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If NO, balance due: $ |
* Please attach a record of monies owed by client
The timesheet must be completed DAILY by the client or other authorized individual. If a client chooses to use a discretionary day, the client must sign in the space provided for that date. A separate timesheet must be completed for EACH child. Timesheets must be COMPLETED and SIGNED by both the CLIENT AND PROVIDER at the end of each month to receive payment. Timesheets are DUE in the office listed above by 5:00 PM on the FIFTH business day of the month following the service period. Timesheets received after the FIFTH business day will be processed at the next available reimbursement period. Billings and registration/annual fees must be submitted not later than ninety (90) days after the month of service or are not eligible for payment approval.
We, the undersigned, certify the accuracy of the information submitted and understand that this information may be audited by either the Division of Welfare and Supportive Services (DWSS) or The Urban League Child Care Subsidy Program, and that any overpaid benefits will be recovered.
Parent Signature |
Provider Signature |