Fill in a Valid Kids Redetermination Template

The Kids Redetermination form is an essential document used by the State of Illinois to assess and confirm a family's eligibility for child care assistance. This form ensures that parents or guardians who are seeking financial support for their child care needs provide accurate and complete information to the Department of Human Services. If you are ready to fill out the form, please click the button below.

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The Kids Redetermination form is an essential document that ensures families in Illinois continue receiving child care assistance. This form is designed specifically for income-eligible families who need help with child care expenses while they work, attend school, or participate in training programs. Completing it accurately is crucial, as any missing information can lead to delays or even cancellation of assistance. Parents or guardians must fill out all sections carefully, including employment information, school details, and household demographics. Additionally, it’s vital to attach the necessary documentation, such as paycheck stubs or school schedules, to verify your current situation. The form also requires that social security numbers be clearly listed, although they are not mandatory for eligibility. Furthermore, confidentiality is assured for all the information provided. Time is of the essence; failure to return the completed form within 10 business days may result in the loss of your child care assistance. Make sure to keep a copy for your records, and consider contacting your local Child Care Resource and Referral center if you need help navigating the process.

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 ##

Click for Kids Redetermination File

File Breakdown

Fact Name	Details
Governing Law	The Kids Redetermination form operates under Illinois state law related to child care assistance, specifically the Illinois Child Care Assistance Program.
Purpose	This form aims to determine ongoing eligibility for child care assistance for families working or attending school.
Submission Deadline	Completed forms must be submitted within 10 business days to avoid cancellation of child care services.
Required Attachments	Verification of employment, copies of pay stubs, or school schedules must be included as specified in the instructions.
Confidentiality	All personal and household information submitted is confidential and will not be shared, ensuring the privacy of families.
Multiple Signature Requirement	Both parents or guardians must sign the Redetermination form to validate its submission.
Social Security Numbers	While not mandatory, social security numbers may be provided to assist in the assessment of eligibility for assistance.
Household Information	Section 3 of the form requires complete details of all household members, including children's immigration status, if applicable.

Guide to Using Kids Redetermination

Completing the Kids Redetermination form is an important step in ensuring your eligibility for child care assistance continues smoothly. Following the instructions closely will help you gather all the necessary information and complete the form correctly. Once you submit your completed form to the appropriate authority, they will process your information to determine your ongoing eligibility for the program.

Start by obtaining the Kids Redetermination form. Ensure you have a blue or black pen to fill it out.
Provide your personal information at the top of the form, including your name and date of notice.
Fill out Section 1 with your current work information. Indicate your job title, employer name, and address, as well as your work telephone number.
Enter your employment details, such as when you started the job and how much you earn before deductions. Select how often you get paid and note your typical work schedule.
If you’ve worked multiple jobs, photocopy the work information page and complete a separate section for each job.
If currently in school, provide your school information and attach any required documents, such as your school schedule and report card.
Complete Section 2 if there is another parent or stepparent in your household. Fill in their work or education details and any necessary corrections.
Carefully complete Section 3, which requests information about your children and your household. Don't forget to mention immigration status if applicable.
Double-check that all information is complete, including signing the form on the last page. Make sure all social security numbers are listed or marked "n/a" where applicable.
Attach all necessary documentation to verify your employment or school attendance.
Once you have filled out the entire form, make a copy for your records.
Submit the completed form to your local Child Care Resource and Referral (CCR&R) or child care provider within the designated time frame.

This systematic approach will help ensure that your redetermination is processed quickly and accurately. If any questions arise during the process, don't hesitate to reach out to your local CCR&R for assistance.

Get Answers on Kids Redetermination

What is the Kids Redetermination form?

The Kids Redetermination form is an application used by the State of Illinois to reassess families' eligibility for child care assistance. Families must complete this form to continue receiving financial support for child care while they work, attend school, or participate in other qualifying activities.

Who should complete the form?

The form should be completed by the parent or guardian who is responsible for the child's care. This individual should provide accurate and current information about their employment and educational activities.

What information is required on the form?

When filling out the Redetermination form, ensure to include the following:

Parent/guardian's name and contact information.
Information about all household members.
Employment verification for all working adults in the household.
Education details if applicable, including school schedules and report cards.

How can I verify my employment?

To verify employment, you must attach documentation such as:

Copies of your two most recent paycheck stubs.
A letter from your employer detailing your work start date, pay rate, and work schedule.
Documents for self-employment, including federal income tax returns or business income and expense reports.

What should I do if I have a change in my circumstances?

If your work or school situation changes, it is crucial to update your information on the form. Notify your local Child Care Resource and Referral (CCR&R) office as soon as possible to avoid delays or interruption in services.

What happens if I submit an incomplete form?

Submitting an incomplete Kids Redetermination form will result in it being returned for additional information. This could lead to delays in processing and potential cancellation of your child care assistance. Ensure all sections are filled and required documents are attached.

Will my information be kept confidential?

Yes, all information provided on the Kids Redetermination form is confidential. It will not be shared with any outside parties, and it is only used to determine your eligibility for child care assistance.

How can I get help with the form?

If you need assistance while completing the form, contact your local CCR&R. You can find your local office at this link or call 1-877-202-4453 for support.

Common mistakes

Completing the Kids Redetermination form can be a straightforward process, but many applicants make crucial errors that can delay assistance. One common mistake is failing to use black or blue ink. This seems minor, but forms must be filled out clearly to ensure readability. If the information is unclear, the form may be rejected or returned, causing unnecessary delays in processing.

Another frequent error involves incomplete answers. Applicants often skip sections or leave questions blank, thinking it won't matter. However, every question must be addressed. If a question does not apply, writing "n/a" is necessary to demonstrate that it was not overlooked. This clarity helps streamline the review process and avoid rejections.

Additionally, many forget to include important verification attachments. If someone is working, supplying the last two paycheck stubs is mandatory. Ignoring this requirement can lead to immediate complications for their Child Care Assistance eligibility. Thoroughly checking the form before submission to ensure all necessary documents are attached is essential.

Finally, failing to keep copies of submitted documents is a significant oversight. Applicants should always retain a copy of the completed Redetermination form for their records. Without a copy, it becomes challenging to track submissions or troubleshoot issues that may arise later. These simple yet critical steps can make a substantial difference in the application process.

Documents used along the form

The Kids Redetermination form is part of the process for families in Illinois to verify their eligibility for child care assistance. This form must often be submitted alongside other documents to ensure a complete application. Below is a list of additional forms and documents frequently required in tandem with the Kids Redetermination form.

Employment Verification Form: This document confirms a parent's employment status. It can include details such as the start date, salary, and work schedule. It's crucial for establishing the family's need for child care assistance.
School Schedule: Parents or guardians must provide a copy of their current school schedule if they are enrolled in educational programs. This document must clearly outline class days and times to prove participation in qualifying activities.
Pay Stubs: Families are required to submit copies of their last two pay stubs as proof of income. These documents provide the necessary evidence of earnings and are pivotal to determining eligibility for assistance.
Proof of TANF Participation: If a family is receiving Temporary Assistance for Needy Families (TANF), they must provide documentation related to their participation. This helps confirm ongoing eligibility for child care subsidies.
Tax Return Documents: For self-employed individuals, submitting the most recent Federal income tax return is necessary. This document verifies income and may include all related schedules and attachments to support self-employment claims.

Being thorough in gathering and submitting these documents with the Kids Redetermination form helps facilitate the application process. Families should ensure that they provide accurate and complete information to avoid delays in receiving child care assistance.

Similar forms

The Kids Redetermination form has similarities with several other documents that are often used in similar contexts regarding income eligibility and assistance programs. Below is a list of ten documents that share characteristics or purposes with the Kids Redetermination form:

Application for Child Care Assistance: This document is used to apply for financial aid for child care, similar to the Redetermination, as both require information about income and employment status.
Food Assistance Application: Like the Redetermination form, this application collects detailed financial information to determine eligibility for food benefits.
Medicaid Application: This form also requires personal and financial information to assess eligibility for medical assistance, similar to how the Redetermination assesses child care assistance eligibility.
Temporary Assistance for Needy Families (TANF) Application: This document is used to request cash assistance, requiring proof of income and family needs, echoing the Needs Assessment in the Redetermination form.
Unemployment Insurance Application: This form gathers information about employment history and current income to determine eligibility for unemployment benefits, much like the Redetermination’s focus on work-related information.
School Meal Program Application: Similar to the Redetermination form, this application assesses household income to determine eligibility for free or reduced-price meals.
Housing Assistance Application: This document collects similar personal and financial information to determine eligibility for housing programs, paralleling the Redetermination in its data requirements.
Child Support Modification Request: This request requires information about current income and expenses to make changes, resembling the Redetermination’s focus on financial verification.
Head Start Enrollment Application: This application asks for similar information regarding family income and the number of children, much like the information needed for Redetermination.
Medicare Savings Program Application: This document also assesses financial eligibility based on income and household information, consistent with the Redetermination’s purpose.

Dos and Don'ts

When completing the Kids Redetermination form, it is crucial to follow specific guidelines to avoid delays or issues with processing. Below is a list of things to do and not to do:

Use blue or black ink. Always fill out the form clearly to ensure readability.
Complete all questions. If a question does not apply, indicate "n/a" instead of leaving it blank.
Provide current information. Ensure details reflect your present job or educational status, and notify your provider if anything changes.
Include the parent/guardian's name. This should appear at the top of each page.
Obtain all necessary signatures. Both parents or adults must sign the form on page 12.
List social security numbers clearly. Use "n/a" if not applicable, but remember these are important for eligibility verification.
Complete Section 3 regarding family information. This includes your children’s immigration status, which is necessary for assistance eligibility.
Confirm household members. Include all individuals residing in your home.
Attach documentation for employment or education. Include required documents such as paycheck stubs or school schedules as necessary.
Keep a copy of the completed form. Maintain a record for your references, as original documents will not be returned.

Do not leave questions unanswered. Incomplete forms will be returned, causing delays in your application.
Avoid submitting original documents. Always provide copies since originals will not be returned.
Do not omit necessary attachments. Failure to include required documentation can lead to processing issues.
Do not rely solely on verbal communication. Ensure all information is provided in writing on the form.
Avoid procrastination. Submit the form within the required 10 business days to prevent cancellation of benefits.
Do not ignore updates. If any information changes, promptly inform your CCR&R or child care provider.
Avoid using pencil or non-standard ink colors. Stick to blue or black ink to ensure clarity.
Do not skip the verification process. Understand that all submitted information will be verified against state databases.
Do not assume privacy. Be aware that all information will be treated confidentially but will be cross-checked for consistency.
Do not underestimate accuracy. Ensure all figures and information match with your documents to avoid discrepancies.

Misconceptions

Misconceptions about the Kids Redetermination Form

Misconception 1: The Redetermination form is optional.

Some individuals believe that submitting the Redetermination form is not necessary. In reality, timely submission is crucial. Without the completed form, child care assistance could be canceled, disrupting care for children.

Misconception 2: Only working parents need to fill out the form.

This is a common misunderstanding. Both working and non-working parents or guardians, including those attending school or training, are required to complete the Redetermination process, as it assesses continued eligibility for child care assistance.

Misconception 3: Social security numbers are mandatory.

While many think social security numbers (SSNs) are required, it is important to note that they are not mandatory for parents or children. However, providing SSNs helps in verifying eligibility, and all information remains confidential.

Misconception 4: The information on the form is not verified.

Contrary to popular belief, the details provided on the form are subject to verification. State and local databases may be used to confirm the accuracy of the information submitted. Any inconsistencies could lead to delays or cancellation of assistance.

Misconception 5: Missing documents will not affect processing.

This assumption can lead to mistakes. If any required documentation is absent, the Redetermination form will be returned, causing potential delays in approval for the Child Care Assistance Program.

Misconception 6: Redetermination is straightforward and does not require assistance.

Many feel confident filling out the form on their own; however, it's advisable to seek help if needed. The local Child Care Resource and Referral (CCR&R) can provide guidance to ensure all information is correctly completed, mitigating the risk of errors.

Key takeaways

Completing the Kids Redetermination form is essential for families seeking child care assistance. Here are seven important things to consider when filling out this form.

Use clear ink: Fill out the form using blue or black ink to ensure legibility.
Complete all information: Answer every question. If a question does not apply, indicate "n/a" to show it wasn't overlooked.
Include household details: List all individuals living in your household, including children’s immigration statuses. Remember, assistance can be granted regardless of immigration status.
Provide documentation: Attach all necessary documents to verify employment, education, or training. This includes paycheck stubs or school schedules, as applicable.
Verify signatures: Ensure that both you and the other parent or guardian sign the Redetermination form before submission.
Check for completeness: Review the form for any missed questions or missing attachments. Incomplete forms will be returned, potentially delaying assistance.
Keep a copy: Make a copy of your completed form for your records. Submitting original documents may result in their loss.

Following these steps carefully can streamline the process and help avoid delays in receiving child care assistance. Contact your local Child Care Resource and Referral if you need help at any point.