The Provider Enrollment and Registration Form 2620 (2 pages), in conjunction with the Alternate W-9 Form-CIS (2 pages), must be completed to enroll and register as a child care provider with DHHS. Proper completion of this initial enrollment allows a child care provider to be eligible to receive the Child Care and Development Fund scholarship payment for children who are eligible for the program. The Alternate W-9 Form-CIS provides DHHS with the child care provider Taxpayer Identification Number and Certification. If the provider is not enrolled or does not complete both forms accurately and fully, the provider cannot be paid.
Form 2620 and the Alternate W-9 Form-CIS, with original signature, must be returned to:
NH DHHS
ATTN: Bureau of Data Management
Box 2000
Concord, NH 03302-2000
Once enrollment is complete, a unique 5 digit Resource Identification Number is assigned and will be sent to the provider for billing purposes. In order to bill for a particular child, the Child Care Provider Verification Form 2530 must be completed to "link" the child to the provider (which establishes that the provider is caring for the child). To bill for payment, the provider must submit a Child Care Payment Request Invoice Form 2500 per child, per week.
The Internal Revenue Service (IRS) requires NH to send an IRS 1099 form each year to child care providers who have received $600 or more in payments on behalf of parents. |
