Page 383

356

When an acceptable application is determined to be incomplete, the Designee will issue a Child Care Assistance Provider Application - Pended notice identifying the information and/or action needed. See section 4260-1 A. Pending a Provider Application.

4200-6 B. REVIEWING AN ACCEPTABLE APPROVED RELATIVE CHILD CARE PROVIDER APPLICATION FOR COMPLETENESS The Designee will review an acceptable application and supporting documentation to include the following steps prior to determining an application complete: 1. Approved Relative Child Care Provider Application CC42 The Approved Relative Child Care Provider Application CC42 is to be filled out completely. At the time of application, the provider applicant must have signed the Statement of Truth section of the application, which includes attesting they have read, understand and agree to abide by the rules pertaining to program participation. If there are applicable areas not marked, a copy of the form is retained and the original is returned to the applicant to be completed.

2. Child Care Provider Rates and Responsibilities CC12 Approved Relative provider applicants must complete the top portion pertaining to their facility name; contact phone number; physical, mailing, and email addresses; owner name, owner physical, mailing, and email addresses and mark the box for Approved Relative for Provider Type.

Ensure the provider has completed the rate portion by either checking the box indicating the provider’s charges are the same as the State subsidy rate with or without exceptions for specific age groups or levels of care, or by marking the box “My rates are listed below” and completing all applicable information. Approved Relative Providers will not be paid a registration fee by the CCAP.

3. State of Alaska Substitute Form W-9 This is a State of Alaska, Department of Administration, Division of Finance form used by all vendors of the State of Alaska. The provider’s business type is identified as well as their Taxpayer Identification Number. The State of Alaska Substitute Form W-9 is required in order for a VCN to be created in IRIS and ICCIS which