Free Child Care Redetermination Forms and Templates

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What Is a Child Care Redetermination Form? 

A Child Care Redetermination Form is a legal document that confirms the eligibility of a child caregiver to continue receiving Child Care Assistance. Every year, and sometimes even twice or four times a year, individuals who receive Child Care Assistance through government programs must be considered eligible again.

There is no time limit to Child Care Assistance – as long as you meet the eligibility requirements and are in need of child care to continue to work or study, you remain eligible on the basis of the Child Care Assistance Application you filled out to start receiving assistance. Additionally, you will be able to file IRS Form 2441, Child and Dependent Care Credit, and reduce the income tax you owe as a result of expenses incurred for paying a child care provider. 

Child Care Redetermination Forms by State

A Redetermination Form for Child Care should be completed by parents and legal guardians in the month before the approval period ends – for instance, if you are approved through February, you should submit your redetermination form in January. If you do not return the redetermination form by the time indicated in it or if you no longer meet the necessary criteria to be considered eligible for the program, your case will be canceled.

The redetermination process varies from state to state – the states listed above provide specific Child Care Redetermination forms that applicants can download and use:

  1. Arkansas.
  2. Colorado.
  3. Connecticut.
  4. Illinois.
  5. Louisiana.
  6. Maryland.
  7. New York.
  8. Ohio.
  9. Virginia.

If your state is not on the list, authorities have either moved their redetermination forms online or the forms are available strictly at local offices. Contact local authorities for more information.

How to Renew Child Care Assistance?

Generally, a Child Care Redetermination Form requires the following details:

  • Information about all household members – adults and children. Indicate their names, genders, dates of birth, social security numbers and specify their relationship to you, the applicant;
  • Employment history and information about household income. Identify your employer, state your hourly wage and days worked during the week. Attach proof of all earned income and work schedules for the past month. If anyone in your household is self-employed, enter the type of business, monthly income, and expenses. Write down all the unearned income of the household – veteran benefits, unemployment insurance, child support, etc.;
  • Description of your assets – vehicles, investments, real estate, cash, and bank accounts;
  • If you or your children need Child Care Assistance to attend school, provide the details of the educational institution;
  • If you need to look for employment, indicate how many hours per week you spend searching for a job;
  • Description of child care needs. List all children that require child care and identify the child care provider.

Related Templates and Forms:



Sample Form OCFS-4773 "Child Care Eligibility Redetermination Coming Due" - New York

Rate (4.4 / 5) 16 votes
Size: 273 KB
1 page

Form JFS01124 "Re-determination for Child Care Benefits" - Ohio

Rate (4.6 / 5) 24 votes
Size: 1 MB
9 pages

Sample Formulario OCFS-4773-S "Se Acerca La Redeterminacion De Su Elegibilidad Para Recibir Asistencia De Cuidado Infantil" - New York (Spanish)

Rate (4.5 / 5) 11 votes
Size: 499 KB
2 pages

Form IL444-3455E "Child Care Redetermination" - Illinois

Rate (4.7 / 5) 44 votes
Size: 2 MB
12 pages

Formulario 032-25-0147-04-SPA "Solicitud De Servicios Para Subsidio De Cuidado Infantil Y Formulario De Una Nueva Determinacion" - Virginia (Spanish)

Rate (4.7 / 5) 16 votes
Size: 1 MB
11 pages

Form 032-25-0147-04-ENG "Child Care Subsidy Service Application and Redetermination Form" - Virginia

Rate (4.7 / 5) 6 votes
Size: 1 MB
11 pages

Form 615-82-94-0070SP SS-7 "Re-determination of Eligibility Form" - Colorado

Rate (4.3 / 5) 12 votes
Size: 216 KB
11 pages

"Change Report/Redetermination for Eligibility" - Arkansas

Rate (4.8 / 5) 8 votes
Size: 210 KB
2 pages

"Care 4 Kids Application" - Connecticut

Rate (4.7 / 5) 17 votes
Size: 1 MB
5 pages

"Solicitud De Asistencia Para La Infancia" - Louisiana (Spanish)

Rate (4.6 / 5) 7 votes
Size: 402 KB
5 pages

"Application for Childcare Assistance" - Louisiana

Rate (4.7 / 5) 18 votes
Size: 1 MB
5 pages

"Application/Redetermination for Child Care" - Maryland

Rate (4.3 / 5) 7 votes
Size: 372 KB
8 pages