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Report a Change

  1. Child Care Services (CCS) will contact you within five (5) business days of receipt of the request.

  2. If selecting "Married," provide a copy of the marriage certificate, the spouse's Social Security Number, and the spouse's date of birth. If applicable, add spouse to Food Stamps case.

  3. Relationship:

  4. Provide a Child Support Verification Form, copy of birth certificate, and social security number to enroll.

  5. New Dependent:

  6. Provide 2-4 check stubs or a Wage Verification Form.

  7. Type of Change:

  8. Provide a copy of your work schedule.

  9. Change:

  10. Provide a copy of work schedule.

  11. Days of the Week:

  12. Temporarily unable to work due to illness, injury, or maternity leave. Documentation will be required.

  13. Documentation may be required.

  14. Leave This Blank:

  15. This field is not part of the form submission.