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.

INSTRUCTIONS: ARIZONA FAMILY CHILD CARE PROVIDER STATEMENT OF SERVICES (Form CC-221-PD)

Arizona child care providers use a form CC-221-PD to document the services their business provides. This document can be obtained from the website maintained by the Arizona Department of Economic Security.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 1: In the first blank box, enter your last name, first name and middle initial.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 2: In the second blank box, enter the date.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 3: The first section concerns your business. Indicate with check marks which days you are open on.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 4: Enter your opening time on the first blank line of this section, your closing time on the second blank line, and any comments on the third blank line. Indicate with a check mark whether or not you offer drop in service.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 5: Indicate with check marks which age groups you accept.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 6: Enter your full day and part day charges for all age groups, as well as defining what you consider "full day" and "part day."

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 7: Write in any other charges where indicated, note any absence policies and charges, and indicate whether you provide transportation or meals.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 8: Note which holidays you are closed on.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 9: At the bottom of the first page, write out your daily activities, planned schedule, material and equipment for children.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 10: On the second page, document your education by indicating the highest grade level you have completed with a check mark. Provide all written explanations requested concerning your experience in providing child care, special skills or knowledge of child care, behavior or discipline methods used, hobbies and special interests, and a description of outdoor and indoor areas where child care occurs.

Arizona Family Child Care Provider Statement Of Services CC-221-PD Step 11: Sign and date the second page.