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2013-2014 Confidential Income Statements - Family Day Care Homes

  • 2013-2014 Confidential Income Statement - Centers and Family Day Care Home Providers (English and Spanish)

  • 2013-2014 Confidential Income Statement - Family Day Care Tier 2 (English and Spanish)

  • Letter to Provider (Tier 1) - (English and Spanish)

  • Letter to Tier 2 Families - (English and Spanish)

  • 2013-2014 Income Eligibility Guidelines (July 1, 2013 to June 30, 2014)

    Important Notes:

    1. Download the Letter to Provider and the Letter to Tier 2 Families and insert the appropriate information in the areas of bold brackets (English forms only), prior to distribution.
    2. The Confidential Income Statement (CIS) heading includes "Child Care Centers/Family Day Care Providers." This is the correct form to use for Family Child Care Providers applying for Tier 1 reimbursement for the provider’s own children and/or Tier 1 income eligibility.
    3. The CIS for Family Day Care Tier 2/Family Income is used for families with children in the care of Tier 2 providers who would like to receive Tier 1 reimbursement for day care children. Section 7 includes a place for the parent/guardian to initial if he/she will consent to allow the provider to collect the CIS form.
    4. The CIS “Sponsor Use Only” section on the English forms is on the first page. Copy both sides of the CIS for distribution.




    Contacts
    • Lynne Reinoso Email    (503) 947-5892
      Child Nutrition Program - Program Mrg, Community Nutrition Programs

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