The DSHS 14-417 form, issued by the State of Washington Department of Social and Health Services, serves as a critical access point for families seeking child care subsidies under the Child Care Subsidy Programs (CCSP). This comprehensive application dossier compiles pivotal data ensuring the state's ability to evaluate eligibility for subsidies. Applicants are obliged to detail not only personal information but also extensive insights into their household's financial landscape, including employment details and income proofs for the preceding three months, unless income derives from state cash assistance such as TANF, which is exempted. Moreover, the document addresses stipulations for those newly employed lacking pay stubs, incorporating a procedure for subsequent submission. Critical also is the inclusion of information regarding court-ordered child support. Specific pathways are delineated for Working Connections Child Care applicants utilizing Family, Friends, and Neighbors (FFN) as providers, necessitating further documentation to affirm the provider's eligibility, such as identification, legal work status in the U.S., and background checks. Additionally, Seasonal Child Care applicants face geographic and employment criteria, underscoring the form's nuanced approach to assistance eligibility. The necessity for applicants to itemize children’s living arrangements, school, and childcare schedules, alongside an acknowledgment of rights and obligations under penalty of perjury, encapsulates the form’s exacting but essential role in facilitating childcare support for Washington's diverse families.
| Question | Answer |
|---|---|
| Form Name | Form Dshs 14 417 |
| Form Length | 7 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 45 sec |
| Other names | dshs child care application forms, 2013, dshs child care, BIRTHDATE |
