Form Ccap 15R PDF Details

When starting a new business, one of the first things that you need to do is file your company’s articles of incorporation with the state. This document will outline the basic information about your company, including its name, registered agent, and management structure. The most common type of article of incorporation is Form C-Corp (or sometimes just referred to as a C-Corp). However, there are other types of articles that can be filed depending on the specific business structure that you choose. In this blog post, we’ll take a look at Form Ccap 15R – also known as the California Cooperative Corporation Act. So what exactly is a cooperative corporation? Let’s find out!

QuestionAnswer
Form NameForm Ccap 15R
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameslouisiana department of education ccap rate and availability verification form, louisiana child care assistance rates, ccap 10 form, child care assistance application form

Form Preview Example

CCAP 15R

Louisiana Department of Children and Family Services

OFFICE USE ONLY

Rev. 10/11

Child Care Assistance Program

 

New Provider

12/10 Issue Obsolete

 

 

 

 

 

Rate Change

 

 

 

CHOW

 

 

 

CHOL

 

Provider Rate Agreement

 

New license/other

Name of Provider

Tips Provider No.

License No. If Applicable

Physical Street Address

City, State

Zip Code

Mailing Address, If Different From Above

City, State

Zip Code

Phone Number

Cell Phone Number

Class A

Military Provider

FCDCH Provider

Provider in Child’s Home

School Program Provider

Rate changes should be promptly reported to Provider Directory at the address below.

Please complete the following and include verification of your rates (notice to parents, such as newsletter, bulletin, memo, etc.)

A CCAP Rate and Availability Form will be sent for each child in your case and must be completed and returned in order for you to be paid.

Do you have a Class A license?

Yes

No

 

Are you a Head Start Program?

Yes

No

Do you have special rates for more than one child in a family?

Yes

No

Rate:

 

 

 

Do you serve children with disabilities ages 13 - 17?

Yes

No

 

 

 

 

 

Do you serve children under age 18 who have special care needs because of a mental, physical, or emotional disability, requires specialized facilities, lower staff ratio, or specially trained staff to meet his/her developmental and physical needs?

Yes

No

 

 

 

 

 

 

 

 

 

 

 

If yes, is the rate for this child higher, lower, or the same for other children for whom you provide care?

 

 

Higher

Lower

Same

 

 

 

 

 

 

 

Do you participate in the Child and Adult Care Food Program?

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rates Charged Per Child

 

 

 

 

 

 

 

 

 

 

 

You must complete both sections below, even if you do not currently care for a child in each age group.

 

 

Under 3 Years of Age:

 

 

 

 

 

3 Years of Age and Over:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Full-Time Care

$

 

 

per Day

 

Full-Time Care

$

 

per Day

 

Complete part-time care rates only if you provide part-time care.

 

 

 

 

 

 

 

Part-Time Care

$

 

 

per Hour

 

Part-Time Care

$

 

per Hour

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RETURN TO:

 

 

PROVIDER SIGNATURE AND TITLE

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROVIDER DIRECTORY

 

 

 

 

 

 

 

 

 

 

 

P.O. Box 94065

 

 

 

 

 

 

 

 

 

 

 

Baton Rouge, LA 70804

 

 

PRINT NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CAPS/TIPS REPRESENTATIVE

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

1