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SELF-SERVICE PORTAL

Starting on July 15 and through December 31, 2021, families may receive $250 per child between the ages of 6 and 17 or $300 per child under the age of 6 as a monthly advanced payment for the child tax credit. To see if you are eligible visit https://www.irs.gov and click on “Get Details on the Advance Child Tax Credit”. You can find more information at ChildTaxCredit.gov. If you are in receipt of SNAP and/or Cash Assistance, Publicly Funded Child Care, or Medicaid, these payments will not impact your benefits or eligibility for benefits.

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Purpose: To get information about people living in your home.

Please answer each question before you click 'Continue'.

* Red asterisk indicates required

      Hover over or click this icon for help answering this question.


How many parents/guardians, including parents under 18, live in your home?*
      
In the total number include the people who are responsible for the child(ren) living in the home:
  • Any father or mother of the child(ren)
  • Any adult who has legal custody of a child
  • Any adult who is the guardian of a child
  • Any adult that has the responsibilities of a parent
  • Any minor parent - a parent who is under age eighteen, including those that participate in the Learning, Earning and Parenting (LEAP) program.

Is anyone in your home pregnant?*
      
Some services have home visiting options for pregnant women. If any individual in your home is pregnant, select 'Yes'.

Are there any children living in the home for whom you are responsible?*

Please list all the minor children who live in the home for whom you are responsible:



To add an additional child, click the 'Add Child' button. If you need to remove a child or an empty row, click the box to the left of the 'First Name' and then click the 'Remove Child' button.


   First Name* How old is this
child?*
      Some services have age requirements. Select the age each child will be at the time you plan to enroll in the service.
Do you have concerns
about how this child is
learning and growing?*
      
  • Please select the appropriate response if your child has an Individualized Education Plan (IEP) or Individualized Family Service Plan (IFSP).
  • If your child does not currently have an IEP or IFSP and you have concerns about their growth and/or development including but not limited to walking, talking, learning, and behaving like other children their age, please select 'Yes'.
  • If none of the above are true, please select 'No'.
    Is this child placed
    in your home
    through the foster
    care program?*
          Some services have different requirements for children in foster care. If this child has been placed in your care through the foster care program, please select 'Yes’.
    Is this child a U.S.
    citizen or qualified
    alien?*
          
    • Some services have different eligibility requirements for citizenship of children. Please select 'Yes' if one of the following is true:
    • If none of the above are true, please select 'No'.

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