1. (a) All applicants requesting child care scholarship shall submit to the DO a signed and dated application for assistance, either on paper, via telephone, or electronically, in accordance with He-W 600.

2. (b) In addition to submitting a completed application as referenced in (a) above, the applicant shall provide the following information as verification as required pursuant to He-C 6910.09:

   1. (1) For each member of the assistance group:

      1. a. Full name, including maiden name, if applicable, and any other names used previously;
      2. b. Social security number, if the applicant chooses to provide it;
      3. c. Current physical address and mailing address, if different; and
      4. d. The total amount of gross income from all sources, or net income if self-employed, as described in He-C 6910.06;
   2. (2) A description of the current household composition, such as whether the family lives independently, or with a relative(s) or others, is homeless, or if the child is a foster child;
   3. (3) The telephone number(s) at which the applicant can be reached;
   4. (4) The reason for requesting assistance at the time the application is made; and
   5. (5) The date and US citizenship status of each child in the assistance group for whom the applicant is requesting child care scholarship.
3. (c) The applicant shall participate in the verification and interview process described in He-W 636.01.

4. (d) The applicant shall indicate at the time of application the current child care arrangements, if any, including:

   1. (1) The name of the provider;
   2. (2) The cost of child care; and
   3. (3) Whether the provider is licensed or license-exempt.
5. (e) The application for child care scholarship shall be signed, dated, and submitted in accordance with RSA 167:8.
6. (f) The applicant shall provide all verification required by He-C 6910.09 prior to being determined eligible for child care scholarship.
7. (g) If the applicant provides all required verification pursuant to He-C 6910.09 within 30 days of the date the DO receives the application and meets the eligibility requirements, the applicant shall be eligible for child care scholarship for 12 months, as described in He-C 6910.10.
8. (h) If the applicant does not provide all verification pursuant to He-C 6910.09 within 30 days of the date the DO receives the application, the child care scholarship application shall be denied and the applicant shall be required to submit a new application and participate in another interview, as described in He-W 636.01, in order to determine eligibility.

Source. #7357, eff 9-1-00; ss and moved by #7723, eff 7-1-02 (from He-C 6910.03); (See Revision Note at part heading for He-C 6910) #9474, eff 6-29-09; ss by #10120, eff 5-7-12; amd by #10917, eff 9-1-15; ss by #12221, eff 7-10-17; ss by #13063, eff 7-1-20; ss by #13799, eff 10-28-23; ss by #13951, eff 4-30-24