Reapply Child Care and Development Fund
Returning CCDF applicants and recipients
Reauthorizing for CCDF? (Current Client)
Read these steps.
- Download and fill out the Parent Application Worksheet and have the Provider Information Page completed by the CCDF provider of your choice.
- Make a copy of supporting documentation (e.g., check stubs, ID).
- Email or mail your forms and supporting documentation no later than 1 week prior to your subsidy end date.
Reapplying for CCDF? (Not currently receiving services)
Read these steps.
- Download and fill out the Pre-Application form.
- Email or mail your forms and supporting documentation.
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Geminus CCDF email: ccdf@geminus.care
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Lake County: 8400 Louisiana St., Merrillville, IN 46410
La Porte County: 301 East 8th St., Michigan City, IN 46360
English
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Pre-Application: Form SF 56895 required to be completed prior to applying for CCDF child care.
pdf 1.27 MB
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Eligibility Determination Checklist: Letter from Geminus listing the documentation needed to determine eligibility.
pdf 209.47 KB
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Secondary School Enrollment Verification: Form SF 56896 to be completed by the applicant and the applicant’s secondary education institution to show proof of enrollment.
pdf 1.22 MB
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Name Attestation: Form SF 57096required to complete if applicant goes by more than one name.
pdf 1.17 MB
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Parent Applicant Worksheet: Parent Applicant Worksheet
pdf 1.60 MB
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Provider Information Page: Form SF 56903 must be completed by the CCDF applicant’s chosen child care provider.
pdf 1.30 MB
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Residency Statement: Form SF 57163 to verify residence for renters.
pdf 1.44 MB
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Self- Employment Profit and Loss Form: Form SF 57101 required for applicants who are self-employed in order to provide proof of income.
pdf 1.25 MB
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Swipe card - Hoosier Works For Child Care Card Authorization Form: Swipe card form for primary and secondary card holders.
pdf 1.26 MB
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Tipped Employee Worksheet: Form SF 56904 used to compute proof of income if parent’s income is comprised of or supplemented by customer tips.
pdf 1.22 MB
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Report of Change
pdf 156.20 KB
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Wage Detail Form: Form SF 57100 to be completed by applicant’s employer to provide detailed proof of an applicant’s income.
pdf 176.40 KB
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New Hire
pdf 1.20 MB
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Provider-Parent Statement
pdf 1.74 MB
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Job Search
pdf 168.13 KB
Español
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Presolicitud
pdf 2.13 MB
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Formulario de apelación para el solicitante o cosolicitante
pdf 29.11 KB
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Verificación de inscripción en la escuela secundaria
pdf 1.23 MB
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Autenticación del nombre
pdf 265.84 KB
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Planilla para el padre/solicitante
pdf 2.24 MB
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Información del proveedor del fondo para el desarrollo y cuidado de niños
pdf 302.88 KB
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Declaración de residencia
pdf 1.50 MB
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Resumen de ingresos y gastos con trabajo por cuenta propia
pdf 205.83 KB
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Autorización de tarjeta de Hoosier Works for Child Care solicitante y cosolicitante titulares de tarjeta
pdf 160.64 KB
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Planilla para empleados con propina del programa de vales de CCDF
pdf 1.34 MB
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Detalle de salarios
pdf 154.59 KB
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Documentación para la búsqueda de empleo
pdf 161.53 KB