Form 7264 "Attestation of Child Day Care for Protective Day Care - Child Care Regulation" - Texas

What Is Form 7264?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2020;
  • The latest edition provided by the Texas Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 7264 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.

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Download Form 7264 "Attestation of Child Day Care for Protective Day Care - Child Care Regulation" - Texas

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Form 7264
April 2020-E
Attestation of Child Day Care for Protective Day Care – Child Care Regulation
This form is used to attest that a child enrolled at a child day care operation is in protective day care as authorized by the Texas
Department of Family and Protective Services.
Section A – Identifying Information
Parent Name
Address
City
ZIP Code
Mailing Address (if different)
City
ZIP Code
Parent Phone No.
Parent Work Phone No.
Section B – Authorized Children
DFPS has authorized the following children in my care to receive protective day care.
Child Name
Date of Birth
Section C - Certification
I certify that the information provided here contains no willful misrepresentation or falsification and that it is true and complete to
the best of my knowledge and belief.
Signature of Parent
Date
Form 7264
April 2020-E
Attestation of Child Day Care for Protective Day Care – Child Care Regulation
This form is used to attest that a child enrolled at a child day care operation is in protective day care as authorized by the Texas
Department of Family and Protective Services.
Section A – Identifying Information
Parent Name
Address
City
ZIP Code
Mailing Address (if different)
City
ZIP Code
Parent Phone No.
Parent Work Phone No.
Section B – Authorized Children
DFPS has authorized the following children in my care to receive protective day care.
Child Name
Date of Birth
Section C - Certification
I certify that the information provided here contains no willful misrepresentation or falsification and that it is true and complete to
the best of my knowledge and belief.
Signature of Parent
Date