SAMPLE FORMS - IACCRR

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1. SAMPLE . FORMS . Familiarize yourself with Indiana's Rules & Regulations for Family Child Care Providers. You will notice many of these FORMS include information which exceeds the information required by the Indiana code. Keep on file all required documentation as listed on the following pages. Your licensing consultant will ask for this documentation at the time of his/. her visit. FORMS marked SAMPLE may be substituted. FORMS listed with an * asterisks should not be substituted. 2. Primary Provider (Applicant for Licensure). Required FORMS These FORMS are located in your Application Packet (Located in the front pocket of this manual ). *Application ______. (Send to licensing consultant). *Attestation Statement ______. (Send to licensing consultant). *National Criminal History Check ______. (complete process, results will be sent to licensing consultant). *Consent for Release Crim Hist for homes centers and ministries (Send to licensing consultant) _______. *Taxpayer Identification Request W-9 ______.

SAMPLE FORMS Familiarize yourself with Indiana’s Rules & Regulations for Family Child ... I.D.’s for you, your spouse, workers or volunteers and other household members. You must also send in proof (copy of certificates) of Orienta- ... Family Child Care Orientation Training & Resource Manual Prepared y: The Indiana Association for hild are ...

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