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Illinois Child Care Assistance Forms

Forms

* Note - Internet Explorer must be used to access the forms listed below from the Illinois Department of Human Services. Additional browsers may give an error message and prevent the form from opening.

 

Application-English

Application-Spanish

Locate your local CCR&R return address here

Illinois Department of Human Services forms library

IRS W-9 Form

Child Care Rate Certificate Form

Telephone Billing Agreement Form

 

Resources

Eligibility Calculator for CCAP

Child Care Payment Rates for providers

Parent's Guide to the Illinois Child Care Assistance Program

Child Care Provider's Guide to the Illinois Child Care Assistance Program

Eligibility Criteria for education and training for students needing assistance paying for child care

Income Guidelines to qualify for the Illinois Child Care Assistance Program

Parent Co-payment Rates Effective July 1, 2016

Copay Amount Table for School-Age Children Effective November 9, 2015

DHS Payment Inquiry Website (Payment Look-up)