Child Care Service Billing Reports 620-01-150-15

(Revised 10/1/16 ML #3480)

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The billing form used for CCAP is SFN 616, Child Care Request for Payment.

 

The provider and parent complete an SFN 616 together. At the end of each month, the completed form is signed and dated by both the provider and the parent.

 

The parent or provider can return the form to the county social service eligibility worker.

 

The eligibility worker processes the form. Questions regarding this form should be referred to the county social service eligibility worker for each family.