Child Support Agency

CC-200-FF Certified Family Child Care Provider Application

CC-200-FF Certified Family Child Care Provider Application

 

INSTRUCTIONS: ARIZONA CERTIFIED FAMILY CHILD CARE PROVIDER APPLICATION (Form CC-200-FF)

 

 

To apply for a position as an Arizona certified family child care provider, a form CC-200-FF should be completed. This document can be obtained from the website maintained by the Arizona Department of Economic Security.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 1: Enter your full legal name in the first blank box.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 2: Enter your phone number, including the area code, in the third blank box. The second blank box is for departmental use only.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 3: Enter your Social Security number in the fourth blank box.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 4: Enter your birth date in the fifth blank box.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 5: Enter your full residential address in the sixth blank box.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 6: Enter your mailing address, if different from above, in the seventh blank box.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 7: Enter your email address in the eighth blank box.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 8: Enter directions to your home in the ninth blank box.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 9: Indicate whether your preferred language is English or Spanish with a check mark.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 10: Voluntarily indicate your race and ethnic background if you wish to.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 11: Indicate whether you are a U.S. citizen, eligible to work in the U.S. and whether you are an enrolled member of an American Indian tribe. If yes, write your tribe.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 12: On the remainder of the first page, document your previous marriages, household members, and adult and minor children out-of-home as instructed.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 13: On the second page, provide references as instructed, as wel as information about your housing and back-up child care provider.

 

Arizona Certified Family Child Care Provider Application CC-200-FF Step 14: Sign and date the bottom of the second page.

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CSE-1156A Affidavit of Receipt of Direct Payments

CSE-1156A Affidavit of Receipt of Direct Payments

 

INSTRUCTIONS: ARIZONA AFFIDAVIT OF RECEIPT OF DIRECT PAYMENTS (Form CSE-1156A)

 

 

When a custodial parent has received direct payments from the non-custodial parent in Arizona child support cases, they should file a form CSE-1156A documenting these payments. This document can be obtained from the website maintained by the Arizona Department of Economic Security.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 1: On the first blank line, enter your ATLAS case number.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 2: On the second blank line, enter your court case number.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 3: On the third blank line, enter the name of the custodial parent.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 4: On the fourth blank line, enter the name of the noncustodial parent.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 5: The next section should be completed by the custodial parent. On the fifth blank line, enter the name of the custodial parent.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 6: On the sixth blank line, enter your ATLAS case number.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 7: On the seventh blank line, enter the court case number.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 8: On the eighth blank line, enter the county in which your case was filed.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 9: On the ninth blank line, enter your state.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 10: On the tenth blank line, enter the name of the parent making payments.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 11: The next section should be completed by the noncustodial parent. On the first blank line, they should enter their name.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 12: On the second blank line, the total amount of payments made should be entered.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 13: On the third and fourth blank lines, the beginning and ending dates of these payments should be entered.

 

Arizona Affidavit Of Receipt Of Direct Payments CSE-1156A Step 14: Document payments made on the second page. Both parties should sign and date the first page in the presence of a notary public.

Download the PDF file .