This page is displayed because you told us that this person pays for someone's care.
If someone in your household does not pay for child care, click the Previous button to navigate back to the Other Bills Survey page to correct the information entered.
Some items have an asterisk (*) next to them, indicating they are mandatory. You must fill in these items before you can continue to the next page.
Payment Information
When entering Amount paid, only enter two decimal places. Special characters, such as commas, are not allowed.
Provider Information
Address should only contain letters, numbers and ‘-‘, ‘#’, and ‘/’. City should only contain letters. Zip Code should contain only numbers.
Click the Print button to print this page for your reference.
If you are applying for SNAP, FITAP, and or KCSP you may click the Complete button to navigate to the end of the application where you can review the rights and responsibilities, sign, and submit the application. Please note that if you are applying for Child Support Enforcement services all required fields must be completed before you can submit your application.
Click the Next button to save and continue with the online application.
Click the Save & Exit button to exit the online application and save your progress on your application. The application is saved as Incomplete.