INSTRUCTIONS: ARIZONA REGISTRATION AND EMPLOYMENT HISTORY FOR PROVIDING DES-CERTIFIED CHILD CARE SERVICES (Form CC-201A)

When a person is hired to provide child care services in Arizona, they are required to complete a form CC-201A. This document can be obtained from the website maintained by the Arizona Department of Economic Security.

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 1: In the first blank box, enter the date.

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 2: Indicate with a check mark whether you are an applicant, a household member, or filing a back-up copy.

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 3: In the second blank box, enter the name of the person being fingerprinted.

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 4: In the third blank box, enter the Social Security number of the person being fingerprinted.

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 5: In the fourth blank box, enter the occupation of the person being fingerprinted. 

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 6: If the child care provider's name is different from the above, enter it in the fifth blank box.

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 7: In the next section, detail your employment history for the last five years by giving each employer's name, address and phone number, as well as your job title, employment dates and reason for leaving. Attach additional sheets if you need more space to document your employment history for the last five years.

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 8: Indicate with a check mark whether or not you give DES permission to contact the listed employers. If not explain why.

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 9: Indicate with a check mark whether you have ever been employed to work with children. If yes, list the applicable employer's name and address.

Arizona Registration And Employment History For Providing DES-Certified Child Care Services CC-201A Step 10: Answer all remaining questions and detail your household composition as instructed.

INSTRUCTIONS: ARIZONA WAIVER OF PATERNITY AFFIDAVIT (Form CSE-1016A)

When an Arizona husband is or was married to a woman who gives birth to a child which is not his and he wishes to waive all legal rights to the child, as well as the right to be notified or or appear at any hearing concerning the child in question, they do so by filing a form CSE-1016A. Those who wish to complete the document in Spanish should use form CSE-1016S instead. Both documents can be obtained from the website maintained by the Arizona Department of Economic Security. When completing this document, type or print your entries on the blank lines using black ink.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 1: This form must be completed in the presence of a notary public.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 2: On the first blank line, enter your state.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 3: On the second blank line, enter your county.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 4: On the third blank line, enter your first name, middle initial and last name.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 5: On the fourth blank line, enter the mother's name.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 6: On the fifth, sixth and seventh blank lines, enter the name of all children concerned.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 7: On the eighth blank line, enter the name of the child's mother.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 8: On the ninth blank line, enter the date. 

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 9: On the tenth blank line, enter your signature.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 10: The notary public should enter their signature and the date on which their commission expires, as well as the date on which you made your appearance before them.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 11: This affidavit should be kept on file in case it is needed in future child support custody cases.

Arizona Waiver Of Paternity Affidavit CSE-1016A Step 12: In the event that you require further assistance in completing this document or to request a copy in an alternative format, call the telephone number which is listed at the bottom of the page.