Work Schedules for Child Care Authorization Form
This file contains essential instructions on filling out the Work Schedule for Child Care Authorization. It is crucial for applicants seeking child care assistance to provide accurate work schedules. Ensure you understand the requirements to avoid any delays.
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How do I fill this out?
To fill out this form, gather all necessary information including your typical work schedule. Complete the form accurately, ensuring all details regarding employment hours are correct. Review the information before submission to ensure compliance.

How to fill out the Work Schedules for Child Care Authorization Form?
1
Gather your work schedule information.
2
Complete the FIA-1100 work schedule form.
3
Provide accurate details for each employed parent/guardian.
4
Submit the form on the same day of the interview.
5
Return the completed FIA-1100a to the appropriate agency.
Who needs the Work Schedules for Child Care Authorization Form?
1
Individuals applying for Cash Assistance who report employment income.
2
Parents needing child care assistance due to work obligations.
3
Employees whose work hours have changed and need to verify them.
4
Child care providers receiving payments through ACCIS.
5
Individuals applying or receiving Child Care in Lieu of Cash Assistance.
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What are the instructions for submitting this form?
To submit the Work Schedule for Child Care Authorization form, you must ensure it's filled out completely and accurately. Email the completed form to the designated child care assistance email provided on the agency's website, or fax it to the listed fax number. You can also submit the form physically to your local Family Independence Administration office, following their guidelines for submission.
What are the important dates for this form in 2024 and 2025?
Important dates for this form may include application deadlines related to child care services for 2024 and 2025. It is crucial to stay informed about any specific submission periods as they can vary each year. Keep an eye on updates related to these dates as they are vital for timely support.

What is the purpose of this form?
The purpose of the Work Schedule for Child Care Authorization form is to provide accurate documentation of an applicant's work hours. This ensures that child care assistance can be appropriately allocated based on actual employment needs. Proper completion of this form is necessary for compliance with regulations and securing benefits.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant's Name: Enter the full name of the applicant requesting child care assistance.
- 2. Employer's Name: Provide the name of the employer for verification.
- 3. Work Hours: Document the standard hours worked weekly.
- 4. Employment Status: Indicate whether the employment is part-time or full-time.
- 5. Verification Signature: A place for the employer to sign, validating the work hours provided.
What happens if I fail to submit this form?
Failing to submit this form can result in delays in receiving child care assistance. Without proper documentation of work schedules, applications may be denied or postponed. It is vital to adhere to submission guidelines to ensure compliance.
- Delayed Assistance: Not submitting the form may delay any potential child care assistance.
- Application Denial: Failure to provide necessary information can result in the rejection of your application.
- Increased Scrutiny: Incomplete submissions may lead to further inquiries or verification processes.
How do I know when to use this form?

- 1. Applying for Assistance: When completing the application for child care aid.
- 2. Updating Work Hours: If your work schedule changes, submit a new FIA-1100.
- 3. Verifying Employment: To verify employment for ongoing assistance needs.
Frequently Asked Questions
What is the purpose of the Work Schedule for Child Care Authorization form?
This form is used to document work schedules when applying for child care assistance.
Who needs to fill out the FIA-1100?
Individuals applying for Cash Assistance or child care help must complete this form.
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Yes, you can easily add your signature to the PDF using the signing tool.
How do I share my completed PDF?
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What do I do if I can't fill out the form at the interview?
You can complete and submit it later at your child care return appointment.
Are there any deadlines for submitting this form?
It's important to submit the form as soon as possible to avoid delays in assistance.
Can I reference my work schedule from a previous job?
No, the form requires your current work schedule for verification.
What should I do if my work hours change?
You must fill out a new FIA-1100 form to update your child care assistance.
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