Forms & Packages for Current Participants
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- Adding a Child/Children Package [PDF - 143KB]
Used by Members currently participating in the USCG CCS Program to add one or more children.
- Annual Recertification Process: The U.S. Coast Guard Child Care Subsidy Program was created to assist qualifying active duty Members and reservists who have been called to active duty for 180 days or longer with child care expenses. The program requires that each participant Recertify annually in order to determine their continued eligibility to participate in the USCG CCS Program. Please visit the Annual Recertification Process for a complete package.
- Authorization for Release of Information USCG [PDF - 38KB]
Used to provide a school, employer, or medical facility with authorization to release information to the USDA in order to support an application for the USCG CCS Program.
- Certification of Custody [PDF - 138KB]
Used when a legal Custody Agreement has not been filed with courts. This form is not considered a permanent record.
- Certification of Higher Education [PDF - 145KB]
To be used when a Spouse/Partner is enrolled in school. When properly completed, this form will ensure that the USDA has all required information in conjunction with the school schedule.
- Certification for Seeking Employment or Enrolling in School [PDF - 125KB]
Allows Temporary Authorization to receive USCG CCS while the Spouse/Partner seeks employment and/or enrolls in school.
- Certification of Self Employment [PDF - 96KB]
Must be completed when Member, Spouse, or Partner is self-employed.
- Certification for Withdrawal from Program or Child/Children Withdrawal [PDF - 196KB]
Used when a Member/Family wishes to be officially removed from the program or is removing one or more children from the program.
- Change-Update to Personal Situation Package [PDF - 830KB]
Used by Members who have a change in their personal situation to include Marriage, Divorce, or Separation from their Spouse or Partner or in situations where a Partner has moved into the home or out of the home.
- Family Enrollment Provider Cost Verification [PDF, 80KB]
Used to provide rates, attendance, and enrollment information to the USDA in order to calculate a USCG CCS benefit. Must be completed and signed by the Provider.
- Member/Family Update [PDF, 133KB]
Used to update Address, Phone, Email, Family Status, and/or custody of a child/children.
- Notification of Maternity Leave [PDF, 179KB]
Used to inform the USDA when a Member, Spouse, or Partner will be out of work due to maternity leave.
- Permanent Change of Duty Station (PCS) Reactivation: The U.S. Coast Guard Child Care Subsidy Program requires that Members, who have undergone a PCS move, complete the Permanent Change of Duty Station (PCS) Reactivation Process in order to update their information on file with the USDA Child Care Administration Program when preparing to Reactivate their USCG CCS benefit.
- Provider Change Request [PDF, 321KB]
Used by Members currently participating in the USCG CCS Program to change providers.
- Request for Benefits to be Placed in an Inactive Status [PDF, 134KB]
Allows a Member to remain in the program for up to 90 days while not actively receiving benefits.
- Request for Reactivation of Benefits Package [PDF, 1.16MB]
To be used when a Member/Family's benefit has been placed in an Inactive Status that is not due to a Permanent Change of Duty Station (PCS) move, and the Member/Family is requesting a Reactivation of benefits.
- Separation Verification [PDF, 233KB]
Used to support eligibility when a legal document has not been issued by the courts. This form is not considered a permanent record.
Applying for a USCG Child Care Subsidy Benefit
Members who are applying for the first time and those who were previously enrolled, but not currently participating in the program, please visit the USCG Child Care Subsidy Program Application Process page for a complete enrollment package.