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

When applying for a position as an Arizona certified family child care provider, an application must be submitted using a form CC-200-FF. If there is not sufficient space on this form to document all household members or adult and minor children who live out of your home, use a supplemental form CC-200-A-FF to document them. This form can be obtained from the website maintained by the Arizona Department of Economic Security.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 1: At the top of the page, enter your last name, first name and middle initial.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 2: The first table provided is for documentation of household members including your spouse. In the first column, enter the last name, first name and middle name of all household members.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 3: In the second column, enter the birth date of all household members.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 4: In the third column, enter the Social Security number of all household members.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 5: In the fourth column, write the relationship of this household member to you.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 6: In the fifth column, indicate with a check mark whether or not each household member is 18 years or older.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 7: The next table provided is for documentation of adult and minor children who do not live in your home. Include your spouse's children and step-children. In the first column, enter the last name, first name and middle name of all such adult and minor children.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 8: In the second column, give the birthdate of all minor and adult children.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 9: In the third column, give the Social Security number of all minor and adult children.

Arizona Certified Family Child Care Provider Application (Addendum) CC-200-A-FF Step 10: In the fourth column, give the relationship of all minor and adult children. In the last column, indicate with a check mark whether they are 18 or older.

INSTRUCTIONS: ARIZONA CERTIFIED PUBLIC EXPENDITURES STATEMENT (Form CS-016-FF)

When spending public expenditures as part of the operations involved in child support enforcement, Arizona public officials use a form CS-016-FF to certify these expenses. This document can be obtained from the website maintained by the Arizona Department of Economic Security. This form should be filed on a monthly basis.

Arizona Certified Public Expenditures Statement CS-016-FF Step 1: Enter the county name and the month being reported at the top right-hand corner.

Arizona Certified Public Expenditures Statement CS-016-FF Step 2: Indicate with a check mark whether the expenditures being documented were incurred by a county attorney, clerk of Superior Court, sheriff or family law commissioner.

Arizona Certified Public Expenditures Statement CS-016-FF Step 3: Enter the name of the person preparing this return, the date and phone number.

Arizona Certified Public Expenditures Statement CS-016-FF Step 4: On line 1, enter the expenditures for public services.

Arizona Certified Public Expenditures Statement CS-016-FF Step 5: On line 2, enter expenditures for employee-related expenses.

Arizona Certified Public Expenditures Statement CS-016-FF Step 6: On line 3, enter expenditures for professional and outside services and specify.

Arizona Certified Public Expenditures Statement CS-016-FF Step 7: On line 4, enter travel and per diem expenditures.

Arizona Certified Public Expenditures Statement CS-016-FF Step 8: On line 5, enter expenditures related to your workspace including rent and utilities.

Arizona Certified Public Expenditures Statement CS-016-FF Step 9: On line 6, enter equipment costs including maintenance.

Arizona Certified Public Expenditures Statement CS-016-FF Step 10: On line 7, enter expenditures for materials and supplies.

Arizona Certified Public Expenditures Statement CS-016-FF Step 11: On line 8, document operating expenses.

Arizona Certified Public Expenditures Statement CS-016-FF Step 12: On line 9, enter indirect costs.

Arizona Certified Public Expenditures Statement CS-016-FF Step 13: On line 10, enter the total of your expenditure fees.

Arizona Certified Public Expenditures Statement CS-016-FF Step 14: Lines 11 and 12 should only be completed by the Child Support Enforcement office.

Arizona Certified Public Expenditures Statement CS-016-FF Step 15: Enter total credits allowed on line 13.

Arizona Certified Public Expenditures Statement CS-016-FF Step 16: Complete the rest of the lines as instructed.

Arizona Certified Public Expenditures Statement CS-016-FF Step 17: Sign and date the bottom of the page, as well as providing your title.