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Fill Out Your Kids Redetermination Form

The Kids Redetermination Form is a vital document utilized by the State of Illinois to assess the eligibility of families seeking child care assistance. This form ensures that income-eligible families can continue to receive support for child care while engaging in work or educational activities. Completing this form accurately is essential to avoid interruptions in child care services.

For those interested in applying or renewing their eligibility, please fill out the form by clicking the button below.

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Article Structure

The Kids Redetermination form is an important tool for families in Illinois who receive child care assistance. This form helps ensure that qualifying families continue to receive support as they work, study, or engage in training. Families must fill out several sections accurately. Information required on the form includes the parent's current employment status, educational activities, and details about all household members. Parents are asked to document their income and expenses, along with providing any necessary verification, such as pay stubs or school schedules. It's crucial that all questions are answered completely or marked as not applicable to avoid delays or complications in the processing of the application. The Illinois Department of Human Services emphasizes confidentiality, assuring families that their private details will remain secure and will solely be used to determine eligibility for child care assistance. Failure to provide complete information could result in cancellation of benefits, so understanding the form's requirements and seeking help if needed is essential for maintaining much-needed care support.

Kids Redetermination Example

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

Client:

Parent/Guardian Name:

Date of Notice:

KEEP FOR YOUR RECORDS

The State of Illinois helps income eligible families pay for their child care services while they work or go to school, training and other work-related activities. To apply please read the following pages carefully and then submit your completed Redetermination to your local Child Care Resource and Referral (CCR&R) or child care center/home if they have a contract with IDHS to provide child care assistance. If you have any questions about your eligibility or if you need help completing this form, call your local CCR&R. To find your local CCR&R go to http://www.inccrra.org/find-your-local-ccrr-other or call 1-877-202-4453 (toll-free).

Please be sure that all of the information is complete before sending in your Redetermination:

*The Redetermination is filled out clearly in blue or black ink.

*All questions on the Redetermination are complete. If the section or question does not apply, write "n/a in the box to show that the question was not missed.

*This information is for your current job/education activity. You will inform the CCR&R or Site provider if any information changes in the future.

*The parent/guardian's name is listed at the top of each page of the Redetermination.

*Both you and the other parent/adult have signed the Redetermination (page 12).

*All social security numbers are listed clearly or "n/a" is listed in the box. Social security numbers are not required for parents or children but they are used to gather information to help determine your eligibility for child care assistance. All information is confidential and will not be shared with anyone else.

*All Family Information is complete in Section 3 (page 7) including information about your children's immigration status. Children can get assistance regardless of their immigration status, but IDHS is required to ask for this information. This information will not be shared with anyone. Your child's alien registration number must be listed if they have one.

*All persons living in your household are listed in Section 3 (page 7).

*If working, at least one of the following is attached to verify your employment and the employment of everyone listed in your family size that is 19 years of age or older:

**Copies of your last (2) paycheck stubs, or if you have not been working long enough to get two paychecks:

--A letter from your employer or an employment verification form listing the following:

The date you started working.

The amount of money you are paid.

Your typical work schedule, including the total number of hours you work per week.

Your employer's address and phone number.

Your employer's signature, or

**Verification of your self-employment. This can include:

--A copy of your most recent Federal income tax return (IRS 1040) and all schedules and attachments.

--A copy of your quarterly estimated taxes.

--A listing of all business income and expenses for the last 30 days. This can be reported on your own form or on a Self-Employment form which can be downloaded at http://www.dhs.state.il.us/OneNetLibrary/27897 /documents/Forms/IL444-2790.pdf or requested from your local CCR&R. When reporting income and expenses, receipts, invoices, or other documentation must be attached to verify all information.

*If in school, ALL of the following are attached:

**Copies of your official school schedule.

**Copies of your most recent report card showing your cumulative grade point average (GPA).

*You have made a copy of your Redetermination for your records. You understand if you send original check stubs or other documents that they will not be returned.

*All jobs and income information for BOTH parents have been reported on pages 3 through 6 and documentation is attached.

*You understand that if any questions are left blank or if any attachments are missing, your redetermination form will be returned to you as incomplete. This may cause a delay in approval for Child Care Assistance Program payments.

*You also understand that all of the information you submit will be verified using State and/or local databases and the internet. If any inconsistencies are discovered, your redetermination may be delayed or your participation in the Child Care Assistance Program may be cancelled.

IL444-3455E (R-6-11)

Page # of ##

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

Child Care Case Number:

Parent/Guardian Name:

	Client:
	Client:	Date of Notice:
		Date of Notice:
		Return your completed Redetermination to:
	Caseload Code:	Reason for Child Care:
	Caseload Code:	Provider(s):
		Provider(s):

Your eligibility for CHILD CARE needs to be Redetermined at this time. Please complete and return this form to us at the address

listed above. If we do not receive this information within 10 business days, your child care will be CANCELED. If you are having problems filling out this form, please contact us.

IF YOU'RE EMPLOYED, ATTACH COPIES OF YOUR 2 MOST RECENT PAYSTUBS.

IF YOU'RE ATTENDING A TANF REQUIRED ACTIVITY (such as education or training), ATTACH A COPY OF YOUR CURRENT RESPONSIBILITY AND SERVICE PLAN (RSP).

IF YOU'RE ATTENDING SCHOOL BUT NOT ON TANF, ATTACH A COPY OF YOUR SCHOOL SCHEDULE AND MOST RECENT REPORT CARD. IF YOU'RE A TEEN PARENT ATTENDING HIGH SCHOOL/GED, ONLY A COPY OF YOUR SCHOOL SCHEDULE IS NEEDED.

PLEASE PRINT CLEARLY IN BLUE OR BLACK INK.

PLEASE READ THE ATTACHED INSTRUCTIONS BEFORE COMPLETING THIS FORM (P. 1).

SECTION 1 - PARENT/GUARDIAN INFORMATION

WORK INFORMATION - If you are working more than one job, you MUST tell us about all your jobs even if don't

Number of jobs currently working

need child care for that job. Photocopy this page and complete a separate work information and work schedule section

for each job you have.

List a phone number where we can reach you during the day:

Current Employer/Company Name

Job Title

Address

City

State

Zip Code

Work Telephone Number

Ext.

Date you started this job:

I earn before deductions (complete one)

per hour OR

per month OR $

per year

I get paid (check one)

every day

every week

Number of hours usually worked at

Number of days usually worked at this

every two weeks

twice per month

this job each week

job each week

once per month

other (please explain)

Travel time from the child care provider to work:

Do you use public transportation?

WORK SCHEDULE: If your schedule varies, provide an example of your schedule.

MON

TUES

WED

THURS

FRI

SAT

SUN

FROM

If your schedule varies, please explain how (you may send additional schedules to show how).

IL444-3455E (R-6-11)

Page # of ##

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

If any of the information on the previous page is incorrect or has changed, Parent/Guardian Name: please complete the following section with your current work information.

New or Corrected Employer/Company Name (Copy and complete additional sheets as necessary)	New or Corrected Job Title

New or Corrected Address

New or Corrected City

State

Zip Code

New or Corrected Work Telephone Number

Ext.

Date you started this job:

Updated or Corrected Pay Information (complete one)

per hour OR $

per month OR $

per year

I get paid (check one)

every day

every week

Number of hours usually worked at

Number of days usually worked at this

every two weeks

twice per month

this job each week

job each week

once per month

other (please explain)

Travel time from the child care provider to work:

Do you use public transportation?

NEW OR CORRECTED WORK SCHEDULE: If your schedule varies, provide an example of your schedule.

MON

TUES

WED

THURS

FRI

SAT

SUN

FROM

If your schedule

varies, please

explain how (you

may send additional schedules

to verify):

Is this a new job since your last redetermination?

Yes

If YES, your previous employer's name:

Date previous job ended:

SCHOOL/TRAINING/TANF-REQUIRED ACTIVITY INFORMATION

Are you currently attending school, training or a TANF-Required Activity?

No (Go to Section 2 - Other Parent/Stepparent Information P. 4)

Yes (Verify/Complete the information below.)

TYPE OF EDUCATION/TRAINING CURRENTLY ATTENDING: (Check one)

Type of Degree Being Earned (GED/High

High School or GED

Below Post - Secondary (e.g., ABE or ESL)

school diploma, trade school certificate, BA

degree)

Occupational/Vocational

2-Year College Degree

Internship

4-Year College Degree

Work Experience (TANF only)

What is the highest level of education you have completed (GED/High school

Do you already have a professional license degree, or certificate? Yes

diploma, trade school certificate, BA degree)?

If yes, what type:

School Name/Training Program Currently Attending

Telephone Number

Term Start Date

Term End Date

Address

City

State

Zip Code

Travel time from the child care provider to school:

Do you use public transportation?

SCHOOL SCHEDULE: Please complete the following schedule

MON

TUES

WED

THURS

FRI

SAT

SUN

FROM

IL444-3455E (R-6-11)

Page # of ##

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

If any of the information on the previous page is incorrect or has changed, please complete the following section with your current school/training information.

Parent/Guardian Name:

NEW OR CORRECTED SCHOOL/TRAINING/TANF-REQUIRED ACTIVITY INFORMATION

TYPE OF EDUCATION/TRAINING CURRENTLY ATTENDING: (Check one)

High School or GED	Below Post - Secondary (e.g., ABE or ESL)
High School or GED	Below Post - Secondary (e.g., ABE or ESL)
Occupational/Vocational	2-Year College Degree	Internship
		Internship

4-Year College Degree	Work Experience (TANF only)

Type of Degree Being Earned (GED/High school diploma, trade school certificate, BA degree)

What is the highest level of education you have completed (GED/High school diploma, trade school certificate, BA degree)?

Do you already have a professional license, degree, or certificate?	Yes	No

If yes, what type:

School Name/Training Program Currently Attending

Telephone Number

Term State Date

Term End Date

Address

City

State

Zip Code

Travel time from the child care provider to school:Do you use public transportation?

NEW OR CORRECTED SCHOOL SCHEDULE: Please complete the following schedule

MON

TUES

WED

THURS

FRI

SAT

SUN

FROM

SECTION 2 - OTHER PARENT/GUARDIAN/STEPPARENT INFORMATION

Is the other parent or stepparent of any of your children, step children or wards living in your home?

No (Go to Section 3 - Family Information P. 7)

Yes (Complete the information below.)

Please note: Information from various agencies' database and internet web sites will be taken into consideration.

If the information does not match it may delay your eligibility.

If the other parent or stepparent could be listed on your case for other benefits (TANF, SNAP/Food Stamps, Medical, Child Support Enforcement, Unemployment) but is no longer living with you, you may need to supply additional information to prove he/she is living somewhere else. If you cannot provide this documentation, please contact your local CCR&R or Site Administered child care provider.

OTHER PARENT/GUARDIAN/STEPPARENT INFORMATION

Other Parent/Guardian/Stepparent First Name		M.I.	Last Name

Social Security Number (Optional)	Date of Birth (include month/day/year)				Telephone Number

Is the other parent or stepparent working?		Yes	No
Is the other parent or stepparent attending school or a training program?			Yes	No

If the other parent or stepparent is not working or in a school/training program, please explain why he/she cannot care for the children.

IL444-3455E (R-6-11)

Page # of ##

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

	Parent/Guardian Name:

WORK INFORMATION - If the other parent/stepparent is working more than one job, you MUST tell us about all their		Number of jobs they are currently working
jobs even if you don't need child care for that job. Photocopy this page and complete a separate work information and
work schedule section for each job they have.

First Employer/Company Name

Job Title

Address

City

State

Zip Code

Work Telephone Number

Ext.

Date they started this job:

They earn (complete one):

per hour OR $

per month OR $

per year)

How often are they paid (check one)

every day

every week

Number of hours usually worked

Number of days usually worked

every two weeks

twice per month

at this job each week

once per month

other (please explain)

Travel time from the child care provider to work:

Do you use public transportation?

Yes

OTHER PARENT WORK SCHEDULE: If their schedule varies, provide an example of the schedule.

MON

TUES

WED

THURS

FRI

SAT

SUN

FROM

If other parent/stepparents schedule varies, please explain how (you may send additional schedules to show how.)

If any information is incorrect or has changed, please complete the following

section with the current work information for the other Parent/Guardian.

NEW OR CORRECTED OTHER PARENT/GUARDIAN/STEPPARENT INFORMATION

Other Parent's New or Corrected Employer/Company Name (Please copy and complete additional sheets as necessary)

New or Corrected Job Title

New or Corrected Address

New or Corrected City

State

Zip Code

New or Corrected Work Telephone

Ext.

Date they started this job:

Updated or Corrected Pay Information (complete one)

per hour OR $

per month OR $

per year

They get paid (check one):

every day

every week

Number of hours usually worked

Number of days usually worked

every two weeks

twice per month

at this job each week

once per month

other (please explain)

Travel time from the child care provider to work:

Do they use public transportation?

Yes

IL444-3455E (R-6-11)

Page # of ##

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

Parent/Guardian Name:

OTHER PARENT WORK SCHEDULE: If the schedule varies, provide an example of the schedule.

MON

TUES

WED

THURS

FRI

SAT

SUN

FROM

If their schedule varies, please explain how (you may send additional schedules to show how.)

OTHER PARENT SCHOOL/TRAINING/TANF-REQUIRED ACTIVITY INFORMATION

Is the other parent/guardian/stepparent currently attending school, training or a TANF-Required Activity?

NO (Go to Section 3 - Family Information P. 7)

YES (Complete the information below)

TYPE OF EDUCATION/TRAINING CURRENTLY ATTENDING: (Check one)

High School or GED	Below Post - Secondary (e.g., ABE or ESL)
High School or GED	Below Post - Secondary (e.g., ABE or ESL)
Occupational/Vocational	2-Year College Degree	Internship
		Internship

4-Year College Degree	Work Experience (TANF only)

Type of Degree Being Earned (GED/High school diploma, trade school certificate, BA degree)

What is the highest level of education they have completed (GED/High school diploma, trade school certificate, BA degree)?

Do they already have a professional license, degree, or certificate?	Yes	No
	Yes	No
If yes, what type:

School Name/Training Program Currently Attending

Telephone Number

Term Start Date

Term End Date

Address

City

State

Zip Code

Travel time from the child care provider to school:

Do they use public transportation?

Yes

OTHER PARENT SCHOOL SCHEDULE: Please complete the following schedule

MON

TUES

WED

THURS

FRI

SAT

SUN

FROM

NEW OR CORRECTED OTHER PARENT SCHOOL/TRAINING/TANF-REQUIRED ACTIVITY INFORMATION

If any of the information above is incorrect or has changed, please complete the

following section with your current school/training information.

TYPE OF EDUCATION/TRAINING CURRENTLY ATTENDING: (Check one)

Type of Degree Being Earned (GED/High

High School or GED

Below Post - Secondary (e.g., ABE or ESL)

school diploma, trade school certificate, BA

degree)

Occupational/Vocational

2-Year College Degree

Internship

4-Year College Degree

Work Experience (TANF only)

What is the highest level of education they have completed (GED/High school

Do they already have a professional license, degree, or certificate?

Yes No

diploma, trade school certificate, BA degree)?

If yes, what type:

IL444-3455E (R-6-11)

Page # of ##

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

NEW OR CORRECTED OTHER PARENT SCHOOL/TRAINING/

Parent/Guardian Name:

TANF-REQUIRED ACTIVITY INFORMATION

School Name/Training Program Currently Attending

Telephone Number

Term Start Date

Term End Date

Address

City

State

Zip Code

Travel time from the child care provider to school.

Do they use public transportation?

Yes

SCHOOL SCHEDULE: Please complete the following schedule

MON

TUES

WED

THURS

FRI

SAT

SUN

FROM

SECTION 3 - FAMILY INFORMATION

Family size includes these people LIVING IN YOUR HOME:

You,

Your biological or adopted children under age 21.

The biological, step or adoptive parent of any of your children must be included.

Any other person related to you by blood or law for whom you provide more than 50% of their support (if you choose to

include them and can verify their income) - for example an elderly parent or disabled person.

My family size:

If any information is no longer correct, please cross out and write in

correct information.

I need child care assistance for the following children:

FIRST NAME

LAST NAME

DATE OF

M/F

ETHNIC

U.S. CITIZEN

SOCIAL SECURITY

WARD OF

BIRTH

ORIGIN*

YES/NO**

NUMBER (Optional)

THE STATE

Yes

*For each child's Ethnic Origin, list all numbers below that apply: (Required for Federal Reporting) 1 - White 2 - Black or

African American 3 - Hispanic or Latino (Persons declaring Hispanic ethnicity should also list their race, for example, "3-1",

"3-2", "3-5") 4 - Asian 5 - American Indian or Alaskan Native 6 - Native Hawaiian or Pacific Islander

** If any of the children are not citizens, provide alien registration documentation if you have it.

List all other family members (not already listed in the Redetermination) counted in your family size:

FIRST NAME

LAST NAME

DATE OF

RELATIONSHIP

SOCIAL SECURITY

BIRTH

TO APPLICANT

NUMBER (Optional)

IL444-3455E (R-6-11)

Page # of ##

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

SECTION 4 - CHILD CARE ARRANGEMENT	Parent/Guardian Name:

If any of the information below has changed, please cross out the wrong information and NEATLY write in the correct
information. Use an extra piece of paper or the bottom of this page, if necessary.

LIST THE CHILDREN CARED FOR BY EACH PROVIDER. If your children go to school, preschool, or Headstart during the day, list only the hours that they are with the child care provider. (This is not a Provider Change Form.)

1) Provider Name:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

IL444-3455E (R-6-11)

Page # of ##

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

Parent/Guardian Name:

2) Provider Name:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

IL444-3455E (R-6-11)

Page # of ##

State of Illinois

Department of Human Services - Bureau of Child Care and Development

CHILD CARE REDETERMINATION

Parent/Guardian Name:

3) Provider Name:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

Child's Name

Age

MON

TUE

WED

THU

FRI

SAT

SUN

FROM

Relationship to Client:

Does the child attend school?

Yes

Year Round

What hours is the child in school?

Does the child care schedule vary?

Yes

If yes, please explain:

IL444-3455E (R-6-11)

Page # of ##

Get Kids Redetermination PDF Form

Form Characteristics

Fact Name	Description
Eligibility for Assistance	The State of Illinois provides financial assistance for child care to eligible families while they work, attend school, or engage in training.
Submission Process	To apply for assistance, families must submit a completed Redetermination form to their local Child Care Resource and Referral (CCR&R) agency or a contracted child care provider.
Complete Information Required	It is essential to ensure that all sections of the Redetermination form are completed. Missing information can lead to delays in processing.
Documentation Requirements	Families must provide documentation such as paycheck stubs, school schedules, and any other relevant verification of income or education.
Immigration Status Inquiry	While children can receive assistance regardless of immigration status, families must provide information relating to this status for compliance purposes.
Confidentiality of Information	All information submitted in the Redetermination process is confidential and will not be shared with unauthorized individuals.
Timeframe for Submission	Families must submit their completed Redetermination within 10 business days to avoid cancellation of child care services.
Use of Social Security Numbers	Although social security numbers are not mandatory, providing them aids in determining eligibility. Families can indicate "n/a" if they do not wish to provide this information.
Understanding Potential Delays	It is crucial for families to understand that incomplete or inaccurate submissions can lead to delays or even cancellation of their participation in the Child Care Assistance Program.

Guidelines on Utilizing Kids Redetermination

Once the Kids Redetermination form is completed, it should be submitted to the designated local Child Care Resource and Referral (CCR&R) or child care provider. Failure to do so within the allotted time frame may result in the cancellation of child care assistance.

Print clearly in blue or black ink.
Fill in the parent/guardian name, date of notice, and other required identification information at the top of each page.
Complete all applicable sections thoroughly. If a question does not apply, indicate by writing "n/a" in the box.
Provide current work information or school details for the parent/guardian and include documentation as needed.
For current employment, attach copies of the last two paycheck stubs or other verification letters from employers, including required details.
For school attendance, include a copy of the current school schedule and the most recent report card.
Complete Section 3 with family information, including immigration status if applicable.
Ensure all social security numbers are clearly listed or marked "n/a" where not applicable.
List all individuals living in the household in Section 3.
Both parents or guardians must sign the form on page 12.
Make a copy of the completed Redetermination form for your records before submission.
Submit the completed form and all required documents to the appropriate CCR&R office or child care provider by the deadline.

What You Should Know About This Form

What is the Kids Redetermination form?

The Kids Redetermination form is a document used by the State of Illinois to help families that are income-eligible to maintain child care assistance. This form is necessary to ensure that the assistance continues while parents or guardians are working, attending school, or participating in other work-related activities. It's essential to complete and submit this form to your local Child Care Resource and Referral (CCR&R) or approved child care provider.

Who should fill out the Redetermination form?

The form should be completed by the parent or guardian who is receiving child care assistance. If there are two parents or guardians involved, both must sign the completed form. Information about all family members living in the household should also be included in the form to provide a full picture of the family's situation.

What information is required on the form?

Complete information about employment, education, and household details must be provided. This includes your current job title, employer information, pay stubs, school details, and information about any other adult living in your home. If some questions do not apply to you, it's important to indicate that by writing "n/a" in the relevant sections. Complete documentation will help avoid delays in processing your assistance.

What happens if I don’t submit the form on time?

If you do not submit the Redetermination form within 10 business days of receiving the notice, your child care assistance may be canceled. It's important to meet this deadline to ensure you continue receiving support. If you're facing challenges in completing the form, reach out to your local CCR&R for assistance.

Do I need to provide any documents along with the Redetermination form?

Yes, to support your eligibility, you need to attach several documents. If you are employed, include copies of your two most recent pay stubs. If you’re in school, provide your official schedule and the latest report card. For self-employment, you might need copies of your tax returns or a summary of business income and expenses.

Is my personal information kept confidential?

Yes, the information you provide on the Redetermination form is kept confidential. Although social security numbers are not mandatory, they help with determining eligibility. Any personal information submitted will not be shared with other parties, so you can be assured of your privacy.

What if my circumstances change after I submit the form?

If there's a change in your job, education status, or any other relevant information after you submit the form, you must inform the CCR&R or your child care provider. Keeping them updated helps maintain your eligibility for child care assistance without interruptions.

How do I get help if I have questions about the form?

If you have any questions while filling out the Redetermination form or about your eligibility, don't hesitate to contact your local CCR&R. They can provide you with guidance and support to ensure your form is completed accurately and submitted successfully.

Common mistakes

Filling out the Kids Redetermination form can be straightforward, but several common mistakes can lead to delays or issues with eligibility. One major mistake is incomplete information. Each section of the form must be filled out completely. If a particular question does not apply to your situation, it’s important to write "n/a" instead of leaving it blank. Leaving questions blank may signal that you overlooked them, which can lead to the form being returned as incomplete.

Another common error is failing to clearly mark the form using blue or black ink. Using a different type of ink or writing that is difficult to read can jeopardize the processing of your application. Clarity is key; make sure that all names, addresses, and contact details are legible. A lack of clarity can delay the processing times unnecessarily.

People often forget to sign the form. There are specific areas where both parents or guardians must sign. Missing signatures will also result in an incomplete submission, which may cause delays in approval for child care assistance. Before submitting, double-check that you and any other responsible adult have signed the form.

Document attachment issues are yet another frequent pitfall. If you're currently employed, ensure that you include the necessary documentation, such as recent paycheck stubs or an employment verification letter from your employer. For those attending school, it is essential to attach your official school schedule and most recent report card. Neglecting to include these documents could lead to your redetermination being delayed or rejected.

Lastly, omitting information about all household members can create problems. It’s vital to provide complete details about everyone living in your household, including their immigration status if applicable. Leaving out this information might raise flags during the verification process, potentially impacting your eligibility for assistance. Always review your form to ensure that no essential details are overlooked.

Documents used along the form

When submitting the Kids Redetermination form for child care assistance, several additional forms and documents are often required. This information helps ensure that your application is complete and that you receive the assistance you need in a timely manner.

Income Verification Documents: These include recent paycheck stubs or self-employment documentation. They confirm your income to determine eligibility for assistance.
School Schedule: If you are attending school, a copy of your official school schedule is necessary. It shows your class times, which helps in planning your child care needs.
Report Card: For students, a recent report card indicating cumulative GPA may be required. This verifies your active status in the educational system.
Current Responsibility and Service Plan (RSP): If you are involved in a TANF-required activity, this document outlines your obligations and goals related to work and education.
Other Parent Information: If applicable, you must provide details about the other parent's work or education status. This information can influence the eligibility assessment for program benefits.

By completing and submitting these additional documents along with the Kids Redetermination form, you help facilitate a smoother and quicker review process. Ensure all information is accurate to avoid delays in receiving child care assistance.

Similar forms

Child Care Assistance Application: Similar to the Kids Redetermination form, this document is used by parents or guardians seeking financial support for childcare. Both forms require detailed information on family income, household members, and other relevant data to determine eligibility.
Food Assistance Application: This form assesses eligibility for assistance programs like SNAP. Like the Kids Redetermination, it collects information about household income and family size while requiring documentation of expenses.
Medicaid Application: Similar to the Kids Redetermination form, the Medicaid application evaluates eligibility for healthcare based on income and household demographics. Both forms require personal information and verification documents.
TANF Application: The Temporary Assistance for Needy Families form shares similarities in that it requests information about income, employment, and household composition to determine financial support eligibility.
Child Support Modification Request: This document is used by parents to modify their child support agreements. Like the Kids Redetermination form, it requires financial disclosure and documentation about changes in circumstances.
Housing Assistance Application: This application assesses eligibility for subsidized housing programs. It parallels the Kids Redetermination form by requesting household income, family details, and supporting documents to establish need.
School Lunch Program Application: This form determines eligibility for free or reduced lunch. It is similar to the Kids Redetermination form as it gathers information about family income and household structure to assess qualification for assistance.

Dos and Don'ts

When filling out the Kids Redetermination form, it's crucial to ensure accuracy and completeness. Here are five essential do's and don’ts to keep in mind:

Do fill out the form using blue or black ink to ensure clear readability.
Do answer all questions completely. If a question does not apply, write "n/a" to indicate it was not overlooked.
Do ensure that you provide your child's alien registration number if they have one.
Don't leave any questions unanswered. Incomplete forms may delay your application.
Don't send original documents; make copies for your records as they will not be returned.

Following these guidelines can help streamline the process and increase the likelihood of a smooth redetermination.

Misconceptions

Misconceptions about the Kids Redetermination form can lead to confusion and potential delays in child care assistance. Here are eight common misunderstandings:

Only certain families can apply for assistance. Many families, regardless of immigration status, can receive help. The form asks for information about children's immigration status for statistical and compliance purposes, but this does not affect eligibility.
Your personal information will be shared. All information submitted is confidential. The Illinois Department of Human Services protects your data and does not share it with unauthorized parties.
You can skip questions that don't apply to you. If a question does not apply, write "n/a" instead of leaving it blank. This practice signals to the reviewers that the question was acknowledged.
Once the Redetermination is submitted, you do not have to follow up. It's essential to ensure all information is complete and correct. If the form is incorrect or incomplete, it may be returned to you, slowing down approval.
All adults in the home must provide Social Security numbers. Social Security numbers are not mandatory for parents or children but may be used to assist with eligibility checks. If not available, indicate "n/a."
Documentation of employment is optional. Attaching relevant employment documentation is crucial. If your family includes adults over 19, proof of their employment is necessary to determine eligibility.
You must have all documents to submit the form. If there are any attachments missing, the application will be deemed incomplete, prompting a delay in processing the child care assistance.
Redetermination is a one-time process. Families must update the CCR&R with any changes in employment or education status, as such changes may impact eligibility for future assistance.

Being aware of these misconceptions can help ensure that families navigate the Redetermination process successfully and maintain their eligibility for child care assistance.

Key takeaways

Complete All Sections: Ensure that every question is answered. If a question does not apply to you, write "n/a" to indicate the question was not overlooked.
Gather Necessary Documentation: Attach required documents such as paycheck stubs, school schedules, or employment verification letters to demonstrate eligibility and support your application.
Keep Records: Make copies of your completed Redetermination form and all attached documents for your records. This will help you keep track of the information you submitted.
Timely Submission: Submit your Redetermination form within the specified timeframe to avoid a lapse in your child care assistance. It is important to address any changes in your situation promptly.

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