Please note: It is best to complete the application on a home computer as some
Required Application Materials:
- Childcare Subsidy Application Form (OPM 1643)
- Childcare Provider Information Form (OPM 1644)
- The employee’s most recent Standard Form 50 (notice of personnel action)
- Two most recent pay statements for each parent or guardian (in household)
- A copy of the most recent Federal Income Tax Return for each parent or guardian (in household)
- A copy of the childcare provider’s current license or state of compliance with State and/or local child care regulations.
- A copy of the provider’s fee schedule.
- A completed IRS Form W-9 from the provider
How to Apply:
Please submit your application using our online form. You will need all of the documents listed above, saved as PDFs, in order to successfully complete and submit your application.
See table above for CBP agency income limit and subsidy scale. Childcare providers are paid directly, after receipt and approval of the prior month’s invoice, by Automatic Clearing House (ACH) electronic payments from FCCS.