Form #

Form Name

Purpose

Application for child care assistance. Package includes:

• Application (CFWB-012)
• Instructions (CFWB-012A)
• Submission Checklist (CFWB-012B)
• Immigration Memo
• Voter Registration Form

Form #

Form Name

Purpose

CFWB-005

Vocational, Education and Training Verification

Submit this form if your reason for care is school or vocational training attendance. This form documents your attendance at an approved education or training program.

CFWB-015

Referral to Employer for Income Information

Use this form to verify your income if pay stubs are not available.

CFWB-015 (Español)

(Español) Remisión al Empleador para Información de Ingresos

Use este formulario para verificar sus ingresos si los recibos de sueldo no están disponibles.

CFWB-026

Work Search Record

Use this form if your reason for care is looking for work if you do not have a current benefits rate letter from New York State Unemployment Benefits.

CFWB-027

Housing Attestation

Use this form if your reason for care is homelessness, and you are living doubled-up, in a place not meant for human habitation, in a hotel/motel, or in another living situation. Families living in shelter (including Humanitarian Emergency Relief Centers) should not submit this form, and should instead submit a Shelter Residency Letter.

CFWB-031

Self Employment Income Information Attestation

For use by self-employed applicants.

CFWB-058

Caretaker Attestation

For use by legal guardian, caretaker relative or other person who lives with the child.

CFWB-067

Residency Attestation

Use this form if you do not have other proof of New York City residency.

Form #

Form Name

Purpose

CFWB-078

Child Care Assistance Recertification
Submission Instructions and Checklist

Instructions and checklist for submitting child care assistance recertification.

Form #

Form Name

Purpose

Form #

Form Name

Purpose

CFWB-009

Referral of Suspected Childcare Subsidy Fraud

Use this form to report child care subsidy fraud in NYC.

Form #

Form Name

Purpose

N/A

Early Care & Education Programs for Families Experiencing Homelessness

For information on all early care and education services available for families in shelter or temporary housing.

N/A

Early Care & Education Programs for New York City Families

For information on all early care and education services available for eligible families in New York City.