In January of each year, Child Care Voucher applications and instructions become available when the W-2 forms are ready.

Completing Your Application
To prove your dependent care expenses, your child care provider(s) for the previous calendar year must sign your application form to verify that you paid them for child care. The completed application also must be signed by you and your agency payroll officer. Please follow the steps below:

1. Obtain an Enrollment Application Form (Form ADM 4306, PDF document, 13KB) and complete the employee portion.

2. Give the form to your child care provider(s) so they can complete their portion, or attach a receipt which includes the following information:
        Provider Name
        Provider Address
        Provider phone number
        Dates care was provided
        Tax ID number (if available) or Social Security number
        Provider signature
   

3. Attach a copy of your federal IRS income tax form IRS 1040, which shows your family adjusted gross income.
   • If you were married as of December 31, your spouse's adjusted gross income must be included, even if you did not marry until the end of the year, or you were separated for part of the year.

   • If you and your spouse file jointly, you must include the IRS 1040 page with the signature and occupation of your spouse.

   • If you and your spouse file separately, a copy of the spouse's IRS 1040 must be included.

   • If you file electronically you must include a copy of the page showing the detailed information. This is often stamped "file copy" by the preparer.

   • You must include your spouse's income unless you were divorced or filed a legal separation agreement, even though you may file as "single, head of household" on your income tax return.

   • If your spouse was in prison during the year and had no income, please provide proof of your spouse's incarceration or a notarized statement indicating the location of the incarceration. Please include the prison phone number and your spouse's inmate number so the prison may be called to verify the information. This applies to only two to three applications per year.

   • If your spouse did not have enough income to have to file a tax return, submit a copy of his or her W-2 form(s).

4. Give your application to your payroll officer to be completed. You must attach a copy of your federal income tax return. Be sure to allow enough time for your payroll officer to complete the form and send it to Benefits Administration Services no later than April 15.

Filing Deadline
In order to be accepted, your application and completed tax form must be date-stamped in Benefits Administration Services by April 15, or postmarked by April 15. No extensions will be given unless your application is under appeal on April 14. Applications submitted without the IRS income tax form, or without the necessary information concerning expenses and your provider, cannot be processed.

Benefits Administration Services will return your application to you if it is incomplete. It is your responsibility to submit all required documentation by April 15 to qualify for the benefit payment.

If you have questions about the Child Care Voucher Program, please speak with your agency's payroll officer or contact Benefits Administration Services at 1-800-409-1205.