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Market Rate Application Form – Registered Family and Licensed Group Providers

Registered family and licensed group providers whose rates listed on file with ACS are not already higher than the 2007 market rate should use this form to apply to receive the new market rate moving forward and retroactively.

Market Rate Application Form – Informal Providers

Moving forward, all informal providers will receive the standard 2007 market rate without having to apply. In order to receive the 2007 rate retroactively, informal providers must apply for it and attest that their cost of care has increased. Please...

Training Record Form – Informal Providers

Informal providers should use this form to record any training sessions they attend. Informal providers who complete 10 or more hours of approved training in at least two different approved topics may be eligible to receive a higher, "enhanced"...

Provider/Program Enrollment or Update Request Form

Administration for Children's Services Division of Child Care/Head Start Child Care Support Services; Provider / Program Enrollment or Update Request

OP 505: Request for Reimbursement of Medical Expenses

Once line-of-duty status has been approved, you can use this form to request reimbursement for out-of-pocket medical expenses to a maximum of $1,500.

Retiree Toolkit: Turning 65/Applying for Medicare

Booklet about applying for Medicare once a member turns 65

Disabled Dependent Child Affidavit

Fill out and have this affidavit notarized to cover unmarried children over age 26 who cannot support themselves because of a mental illness, developmental disability, mental retardation or physical handicap under the UFT Welfare Fund Benefit Plan....

UFT Incident Report

Use this confidential form to notify the UFT School Safety Department if you have been the victim of an incident and/or injury. Or fill out the online incident report form.

C-11: Change of Employment Status

Change in employment status includes return to work, discontinuance of work, increase or decrease of regular hours of work and increase or reduction of wages.

NY Workers Comp Weekly Wage Benefit

The amount of weekly benefits you receive during your period of disability is based on the average weekly wage you were earning at the time of your injury. Initially, you should receive approximately 2/3 of your wages. However, the workers...