Form CCA-0231A "Child Care Assistance Unwed Minor Parent Deeming Worksheet" - Arizona

What Is Form CCA-0231A?

This is a legal form that was released by the Arizona Department of Economic Security - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2020;
  • The latest edition provided by the Arizona Department of Economic Security;
  • 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 CCA-0231A by clicking the link below or browse more documents and templates provided by the Arizona Department of Economic Security.

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Download Form CCA-0231A "Child Care Assistance Unwed Minor Parent Deeming Worksheet" - Arizona

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ARIZONA DEPARTMENT OF ECONOMIC SECURITY
CCA-0231A FORFF (7-20)
Child Care Administration
CHILD CARE ASSISTANCE UNWED MINOR PARENT DEEMING WORKSHEET
Case Name (Last, First, M.I.):
Client ID:
1. Total Monthly Earned Income received by parent of the unwed minor parent.
$
2. Total Monthly Unearned Income received by parent of the unwed minor parent.
$
3. Subtotal (Add lines 1 and 2)
$
4. Number of dependents
; Enter amount required to support the other dependents
according to the Dependent Deduction Chart below (this number includes the parents of the
minor parents, and any of their children and dependents residing in the same household;
this number does not include the minor parent or the minor parent’s children).
$
5. Child Support payments paid monthly for persons living outside of the home.
$
6. Subtotal (Add lines 4 and 5)
$
7. Total income deemed as available to the unwed minor parent. (Subtract line 6 from line 3)
$
8. Earned Income received monthly by the unwed parent.
$
9. Unearned Income received monthly by the unwed parent.
$
10. Total countable income for the unwed parent. (Add lines 7, 8 and 9)
$
11. Enter fee level if the unwed minor parent is eligible for Child Care Assistance.
DEPENDENT DEDUCTION CHART
Income Deducted From Parents
Number of Dependents
Income To Determine Deemed Portion
(Not including minor parent and the minor parent’s child(ren)
(Effective October 1, 2020)
1
$1,756
2
$2,372
3
$2,987
4
$3,604
5
$4,220
6
$4,835
7
$5,452
8
$6,068
9
$6,683
10
$7,300
11
$7,916
12
$8,425*
* Federal Child Care & Development Fund (CCDF) statutory limit is 85% of the Federal Fiscal Year 2021 State median income (SMI).
Equal Opportunity Employer / Program • Auxiliary aids and services are available upon request to individuals with disabilities • To request
this document in alternative format or for further information about this policy, contact your local office; TTY/TDD Services: 7-1-1
ARIZONA DEPARTMENT OF ECONOMIC SECURITY
CCA-0231A FORFF (7-20)
Child Care Administration
CHILD CARE ASSISTANCE UNWED MINOR PARENT DEEMING WORKSHEET
Case Name (Last, First, M.I.):
Client ID:
1. Total Monthly Earned Income received by parent of the unwed minor parent.
$
2. Total Monthly Unearned Income received by parent of the unwed minor parent.
$
3. Subtotal (Add lines 1 and 2)
$
4. Number of dependents
; Enter amount required to support the other dependents
according to the Dependent Deduction Chart below (this number includes the parents of the
minor parents, and any of their children and dependents residing in the same household;
this number does not include the minor parent or the minor parent’s children).
$
5. Child Support payments paid monthly for persons living outside of the home.
$
6. Subtotal (Add lines 4 and 5)
$
7. Total income deemed as available to the unwed minor parent. (Subtract line 6 from line 3)
$
8. Earned Income received monthly by the unwed parent.
$
9. Unearned Income received monthly by the unwed parent.
$
10. Total countable income for the unwed parent. (Add lines 7, 8 and 9)
$
11. Enter fee level if the unwed minor parent is eligible for Child Care Assistance.
DEPENDENT DEDUCTION CHART
Income Deducted From Parents
Number of Dependents
Income To Determine Deemed Portion
(Not including minor parent and the minor parent’s child(ren)
(Effective October 1, 2020)
1
$1,756
2
$2,372
3
$2,987
4
$3,604
5
$4,220
6
$4,835
7
$5,452
8
$6,068
9
$6,683
10
$7,300
11
$7,916
12
$8,425*
* Federal Child Care & Development Fund (CCDF) statutory limit is 85% of the Federal Fiscal Year 2021 State median income (SMI).
Equal Opportunity Employer / Program • Auxiliary aids and services are available upon request to individuals with disabilities • To request
this document in alternative format or for further information about this policy, contact your local office; TTY/TDD Services: 7-1-1