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Administration for Children's Services

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Forms for Providers


Forms for Child Care Programs and Providers

Note: All forms are in PDF format.

Child Care Program and Provider Enrollment Application

This application is for child care programs or providers who are applying to enroll subsidized children for the first time. All new programs and providers must submit these forms.

Form #

Form Name

Purpose

CFWB-048

Child Care Program or Provider Enrollment Application

Submit this form to apply to enroll subsidized children and receive payment for child care vouchers.

CFWB-048 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français

CFWB-050

Child Care Program or Provider Enrollment Application Check List

This checklist explains what documents and forms child care programs or providers must submit to ACS when they are applying to enroll subsidized children for the first time.

CFWB-050 Translations: العربية | বাংলা | Español | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français

N/A

YMS Terms & Conditions for ACS Child Care Program Payment Form

Submit this form to receive child care payments. This form details the terms and conditions for receiving payments through YMS, ACS’s payment agent.

Translations: Español

N/A

YMS Direct Deposit Authorization Form

Submit this form to receive child care payments via direct deposit. This form provides bank information and authorizes YMS, ACS’s payment agent, to make payments to your account.

Translations: Español

N/A

W9 IRS Form

Submit this form to receive child care payments. This form provides your Taxpayer Identification Number (TIN), which is required to approve your application.

Instructions on how to complete these forms can be found at

W9 IRS Form Instructions

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W9 IRS Form Translations: Español | 简体中文 | 繁體中文 | Русский | 한국어 | Kreyòl ayisyen | Tiếng Việt

Child Care Program and Provider Enrollment Application – Supplemental Forms for Informal Providers

These forms are for informal child care providers (relative, friend, or neighbor) who are applying to enroll subsidized children. These forms must be submitted for every new child you enroll.

Form #

Form Name

Purpose

OCFS-LDSS-4699

Enrollment Form For Provider of Legally Exempt In-Home Child Care And Legally-Exempt Family Child Care

Submit this form if you are an informal provider (relative, neighbor, or friend). The New York State Office of Children and Family Services (OCFS) requires that this form be submitted and approved in order for you to provide subsidized in-home or family child care in a residence.

Instructions on how to complete these forms can be found at

OCFS-LDSS-4699a

.

Translations: OCFS-LDSS-4699 Español, OCFS-LDSS-4699a Español

CFWB-004

Identification and Provider Site of Care Verification for Informal Child Care Providers

Submit this form if you are an informal provider (relative, neighbor, or friend). This form provides proof of identity and residency and is required in order to enroll with ACS and receive payment.

CFWB-004 Translations: العربية | বাংলা | Español | 简体中文 | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français

CFWB-047

Background Check for Relative Child Care Providers

Submit this form if you are related to the child or children you will be providing care for (e.g. grandparent, aunt or uncle, sibling). This form allows ACS to conduct a criminal background check and is required in order to enroll with ACS and receive payment.

Child Care Program and Provider Enrollment Application – Supplemental Forms for Legally Exempt Non-Licensed Programs

These forms are for Legally Exempt Non- Licensed Programs who are applying to enroll subsidized children. These forms must be submitted for every new child you enroll.

Form #

Form Name

Purpose

OCFS-LDSS-4700

Part A: Enrollment Form For Legally-Exempt Group Child Care Program

Part B: Enrollment Form for Parent/Caretaker for Legally-Exempt Group Child Care Program

Part A: Legally-Exempt Group Child Care Programs must complete Part A to enroll as a legally-exempt group child care provider.

Part B: Parent/Caretakers must complete Part B to enroll their children in a legally-exempt group child care program.

The New York State Office of Children and Family Services (OCFS) requires that these forms be submitted and approved in order for legally-exempt group child care providers to enroll children receiving a child care subsidy.

Instructions on how to complete these forms can be found at

OCFS-LDSS-4700a

.

Translations: OCFS-LDSS-4700 Español, OCFS-LDSS-4700a Español

Request a Payment Increase

These forms are for families who already enroll subsidized children and are requesting a Market Rate increase. The 2024 Market Rates are effective October 1, 2024. If your cost of care has increased, please submit one of the following attestation forms.

Submit your signed attestation to FSCCrates@acs.nyc.gov or mail to: ACS Financial Services, 150 William Street, 10th floor, New York, NY 10038, Attn: Rate Adjustment Review Unit.

Form #

Form Name

Purpose

OCFS-6060

Child Care Provider Attestation of Costs Form

This form is used to request a Market Rate increase if you serve only children receiving child care assistance.

OCFS-6060 Translations: Español

NYC FS-023

Rate Increase Request Form for Providers with Both Subsidized and Private Pay Providers

This form is used to request a Market Rate increase if you serve both children receiving child care assistance and children who do not receive child care assistance (private pay).

NYC FS-023 Translations: العربية | বাংলা | Español | 简体中文 | 繁體中文 | Русский | 한국어 | Polski | اردو | Kreyòl ayisyen | Français