Dcc 94 Form PDF Details

The Dcc 94 form is an important document that is used to report financial information to the Canada Revenue Agency. This form must be completed by all organizations that are registered as charities with the CRA. The information on the Dcc 94 form helps the CRA determine whether or not a charity meets the requirements for registration and whether it is operating in accordance with its charitable purpose. Non-compliance with the requirements for registration can result in penalties or even cancellation of a charity's registration. It is therefore important that all registered charities complete and submit the Dcc 94 form accurately and on time.

QuestionAnswer
Form NameDcc 94 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdcc 94b form, dcc94, kentucky child care attendance form, dcc 94e form pdf

Form Preview Example

DCC-94E

COMMONWEALTH OF KENTUCKY

 

 

 

 

 

R

(R.07/13)

Cabinet for Health and Family Services

 

 

 

 

 

 

 

922 KAR 2:160

Department of Community Based Services

 

 

 

 

 

 

 

 

Division of Child Care

Page

 

 

 

of

 

Child Care Daily Attendance Record

 

 

 

 

 

 

 

Provider's Name

Provider's Registered/Certified/Licensed #

 

 

Week of:

 

 

 

 

 

 

 

--

 

 

 

 

 

 

(mm/dd/yyyy)

 

through

(mm/dd/yyyy)

Daily Attendance Record: Enter the child’s full name as listed on the DCC-97, Provider Billing Form. The physical arrival/departure time, including a.m. and

p.m., of each child must be recorded daily. A parent or the parent's designated person (i.e., somone other than a child care employee) must sign at the end of each week for each child to verify accuracy. If a child arrives/depart by bus, the child care employee must record the time and initial daily. DO NOT RECORD INFORMATION IN ADVACE or make alterations to this form. No other version of this from will be accepted. This form must be fully completed.

Child's Name

(as it appears on

PBF)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Time In

Time Out

Time In

Time Out

Time In

Time Out

Time In

Time Out

Time In

Time Out

Time In

Time Out

Time In

Time Out

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Initials

Initials

Initials

Initials

Initials

Initials

Initials

Initials

Initials

Initials

Initials

Initials

Initials

Initials

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Parent

or Designated Person to Verify Accuracy of Attendance for the week

I certify that I have not altered this form in accordance with KRS 13A.130, and this information was used when completing the DCC-97, Provider Billing Form. I understand

that if I or staff acting on the child care provider’s behalf does not bill accurately in accordance with 922 KAR 2:160 for a child, the child care provider will not be paid for

days that are not verified and will be required to pay back any overpayment. An overpayment may be pursued as an intentional program violation in accordance with 922 KAR

2:020.

Licensee/On-Site Director or Certified/Registered Provider’s Signature: _________________________________________________ Date: _________________ __

“Licensee”, as defined by 922 KAR 2:090, is an owner or operator of a child care center to include sole proprietor, corporation, Limited Liability Company, partnership, association or organization. NOTE: MISSING SIGNATURES MAY RESULT IN NON-PAYMENT OR RECOUPMENT OF CCAP PAYMENT IN ACCORDANCE WITH 922 KAR 2:160 and 922 KAR 2:020.

Cabinet for Health and Family Services

 

Web Site: http://chfs.ky.gov/

An Equal Opportunity Employer M/F/D

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