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received the date the fax is received and within one (1) business day: a. Register the application in received status; and b. Case note receipt of the application, based on the first date stamp. See section 4200-4 Registering an Acceptable Provider Application.

4200-2 PROVIDER APPLICATION SUBMISSION Providers currently licensed or certified/accredited, individuals interested in becoming an Approved Relative provider, or a family choosing to hire an In-home caregiver, must submit an acceptable and complete application to the Designee. A complete application must be received by the Designee within thirty (30) days of the date the application was submitted in order to participate in the Child Care Assistance Program (CCAP) to receive subsidies on behalf of CCAP participating families.

All pages of the application, forms, and supporting documentation are to be date stamped by the Designee.

4200-2 A. LICENSED PROVIDER CHILD CARE ASSISTANCE APPLICATION SUBMISSION The application packet for a Licensed provider includes the following forms and verification requirements that must be completed and submitted to the Designee:

1. Licensed Provider Child Care Assistance Application CC41;

2. State of Alaska Substitute Form W-9;

3. Child Care Provider Rates and Responsibilities CC12; and

4. The Electronic Payment Agreement for Vendors Doing Business with the State of Alaska form is strongly encouraged and provided to each applicant however is not required. If provided it is forwarded to the Child Care Program Office with the State of Alaska Substitute Form W-9 at the time of program approval; and

5. Verification of completion of the Child Care Assistance Licensed, Certified, or Accredited Provider Orientation.