RSA He-C 6910.04 - Application for Child Care Scholarship
(a) All applicants
requesting child care scholarship shall submit to the DO a signed and dated
application for assistance, either on paper, via telephone, or electronically,
in accordance with He-W 600.
(b) In
addition to submitting a completed application as referenced in (a) above, the
applicant shall provide the following information as verification as required
pursuant to He-C 6910.09:
(1) For each member of the assistance group:
a. Full name, including maiden name, if
applicable, and any other names used previously;
b. Social security number, if the applicant
chooses to provide it;
c. Current
physical address and mailing address, if different; and
d. The total amount of gross income from all
sources, or net income if self-employed, as described in
He-C
6910.06;
(2) A description of the current household
composition, such as whether the family lives independently, or with a
relative(s) or others, is homeless, or if the child is a foster
child;
(3) The telephone number(s)
at which the applicant can be reached;
(4) The reason for requesting assistance at
the time the application is made; and
(5) The date and US citizenship status of
each child in the assistance group for whom the applicant is requesting child
care scholarship.
(c) The
applicant shall participate in the verification and interview process described
in He-W
636.01.
(d)
The applicant shall indicate at the time of application the current child care
arrangements, if any, including:
(1) The name
of the provider;
(2) The cost of
child care; and
(3) Whether the
provider is licensed or license-exempt.
(e) The application for child care
scholarship shall be signed, dated, and submitted in accordance with
RSA
167:8.
(f) The applicant shall provide all
verification required by
He-C
6910.09 prior to being determined eligible for child
care scholarship.
(g) If the
applicant provides all required verification pursuant to
He-C
6910.09 within 30 days of the date the DO receives the
application and meets the eligibility requirements, the applicant shall be
eligible for child care scholarship for 12 months, as described in
He-C
6910.10.
(h) If the applicant does not provide all
verification pursuant to
He-C
6910.09 within 30 days of the date the DO receives the
application, the child care scholarship application shall be denied and the
applicant shall be required to submit a new application and participate in
another interview, as described in
He-W
636.01, in order to determine
eligibility.
Notes
#7357, eff 9-1-00; ss and moved by #7723, eff 7-1-02 (from He-C 6910.03); (See Revision Note at part heading for He-C 6910) #9474, eff 6-29-09; ss by #10120, eff 5-7-12
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