Publicly Funded Child Care Release of Information Form
The JFS 01115 form allows caretakers to grant permission for child care providers to access their publicly funded child care application information. This streamlined process supports families in need of child care assistance. It's essential for families eligible for publicly funded child care (PFCC) benefits.
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How do I fill this out?
To fill out the JFS 01115 form, first download and print the document from the Ohio Department of Job and Family Services website. Next, carefully complete all necessary fields with accurate information. Finally, submit the signed form to your county agency or via the Self-Service Portal.
How to fill out the Publicly Funded Child Care Release of Information Form?
1
Download and print the JFS 01115 form.
2
Complete all required fields with correct information.
3
Sign the form as the caretaker or authorized representative.
4
Submit the completed form to your county agency.
5
Check for any confirmation of processing or follow up as needed.
Who needs the Publicly Funded Child Care Release of Information Form?
1
Caretakers applying for PFCC benefits to allow their provider access.
2
Child care providers needing case information for service delivery.
3
Authorized representatives of caretakers facilitating applications.
4
Families transitioning between child care providers for continuity.
5
Individuals involved in recertification of PFCC benefits.
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What are the instructions for submitting this form?
To submit the JFS 01115 form, you can either upload it through the Self-Service Portal or send a physical copy to your local county agency. For online submissions, access your benefits account at https://ssp.benefits.ohio.gov/. If you choose to submit by mail, address it to your county’s Job and Family Services office; physical addresses can be found on the ODJFS website. Remember to keep a copy of your submission for your records.
What are the important dates for this form in 2024 and 2025?
Important dates related to the JFS 01115 form are typically determined by individual county agency processing times. Make sure to check with your local agency for any specific timelines regarding the PFCC application process in 2024 and 2025.
What is the purpose of this form?
The purpose of the JFS 01115 form is to enable caretakers to grant permission to their selected child care provider, allowing them access to essential application information regarding publicly funded child care. This streamlines the process for families seeking assistance and ensures that child care providers have the necessary information to accommodate children effectively. Additionally, it establishes a clear protocol for sharing sensitive information while maintaining privacy and compliance with regulations.
Tell me about this form and its components and fields line-by-line.
- 1. Caretaker Name: Full name of the caretaker submitting the form.
- 2. Phone Number: Contact number for the caretaker.
- 3. Street Address: Complete mailing address of the caretaker.
- 4. City: City where the caretaker resides.
- 5. State: State of residence.
- 6. Zip: Postal code for the address.
- 7. Caretaker Email: Email address used in the Self-Service Portal.
- 8. Last four digits of Caretaker SSN: Last four digits of the caretaker's social security number.
- 9. Reason for the Consent: The justification for granting permission for information access.
What happens if I fail to submit this form?
Failing to submit the JFS 01115 form may result in delays in processing publicly funded child care applications. Caretakers may face challenges in accessing necessary information for their child care providers without this form.
- Delayed Child Care Services: Without the completed form, the child care provider may lack the required information to begin services.
- Inability to Track Application Status: Caregivers might struggle to obtain updates about their application due to lack of consent.
- Potential Financial Issues: Inadequate access to information can lead to confusion and complications regarding payment for services.
- Complicated Enrollment Process: Enrollment into care programs may be hindered.
- Denial of Service: Providers may be unable to offer services without the necessary information.
How do I know when to use this form?
- 1. Initial Application for PFCC: When applying, this form allows providers to access application statuses.
- 2. Recertification Process: It's crucial during recertification to ensure continuity of providers.
- 3. Change of Child Care Provider: Should a family change providers, this form is necessary.
- 4. Enrollment in Child Care Services: Required for enrollment in specific child care programs.
- 5. To Keep Provider Informed: Maintains communication regarding application statuses for providers.
Frequently Asked Questions
What is the JFS 01115 Form?
The JFS 01115 Form is used to grant child care providers access to case information related to publicly funded child care applications.
How do I fill out the JFS 01115 Form?
Fill out the form by entering the required information, signing it, and submitting it to the appropriate county agency.
Who needs to use the JFS 01115 Form?
Caretakers of children applying for publicly funded child care benefits and child care providers needing necessary case information.
Can I edit the PDF of the JFS 01115 Form?
Yes, you can easily edit the JFS 01115 PDF using the PrintFriendly editor.
How do I submit the completed form?
Submit the completed JFS 01115 form to your county agency or through the online Self-Service Portal.
How long does the consent last?
The consent given through the JFS 01115 form remains effective for 18 months unless revoked earlier.
Can I cancel the consent given?
Yes, the consent may be canceled by providing written notice to the county agency.
What if I need assistance with the form?
For questions about the JFS 01115 form, you can contact the Child Care Policy Help Desk.
Is there a deadline for submitting the form?
It's best to submit the form as soon as the child care provider is approved for services.
What information will be shared?
Basic information about the caretaker and the status of the child's care application will be shared with the child care provider.
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