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1. Signature Request for Payment CC78 are not processed for payment if they have not been signed by an authorized individual. The CCPO will not accept a verbal correction for this requirement.

Licensed, United States (US) Department of Defense or US Coast Guard Certified, Tribally Approved or Tribally Certified, Nationally Accredited or Nationally Certified Day Camps or similar facilities may designate an individual within their facility’s organization to complete and sign the Request for Payment CC78. The signatory designation must be on file with the Designee as part of their provider case file. Designees are to maintain accurate records and advise the CCPO Accounting Staff of changes (deletions and additions) regarding a provider’s signatory authority. The CCPO Accounting Staff should reference the Licensed provider’s signatory designation in the case notes in ICCIS. The Designee and CCPO may maintain another method of tracking signatory designation, to ensure the individual signing the Request for Payment CC78 is authorized.

Approved Relative and In-home Providers may not delegate signatory authority and their Request for Payment CC78 must be signed by the provider. For In-home care, the parent of the family and the In-home caregiver must both sign the Request for Payment CC78.

When a Request for Payment CC78 is not signed or an unauthorized individual signs the form for submission the CCPO will: a. Contact the provider advising their submission must be returned unpaid and may be resubmitted with an acceptable signature. If unable to reach the provider a message is left requesting a return call; and b. Issue a Child Care Assistance Provider Request for Payment Returned -Unpaid Notice identifying the need for anacceptable signature. The action is case noted using the subject heading: MM/YYYY CCA-Request for Pay Returned Unpaid. The body of the case note includes explanation about why the Request for Payment CC78 is being returned unpaid for an authorized signature and their options available for resubmission. 2. Service Month When the service month is missing from the Request for Payment CC78 form the CCPO Accounting Staff must clarify with the