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1. Print 2 copies of the form.
2.
Complete each form.
3. Have
your signature notarized. A
Notary Public can often be found at a
bank or at an attorney's office.
4. Keep
one copy for your records.
5. Return
one copy to your Home Provider
Specialist by either:
Mail: Job and
Family Services
222 East
Central Parkway
Cincinnati, Ohio 45202
Attn: Child Care Provider Program
Fax: (513) 946-1102
Be sure to write your Home
Provider Specialist's name on any forms you mail or fax.
Click here for
form
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