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Form W-10 Minnesota: What You Should Know

Income and Expenses for Child Care in the past 12 months. Income and Expenses for Health Care in the last 12 months. The cost of the care in the last 12 months. All the above information must be completed to enroll and pay for the child care for each child you care for. You must give the name, contact information (phone number and email), and phone number for the person responsible for the care and the children' school address to establish the care. If the person is the licensed caretaker, the information must also be given to the Department. You may be able to complete and submit a form for each child. This form should be given to the Department. All license holders have to keep this form on file. If it is a new licensed caretaker, and we have not received your completed application or the required documents, you must submit the following documentation with the payment order: Payment Card, Check or Cash in any form. If you are a new licensed caretaker, you must notify the Department when we receive your completed application or application forms. If you are out of state or outside the U.S. and can't complete the registration process, call the Department of Revenue at or fax to. You can also submit your application online. Registration is available online through:  Department of Social Services Child Care Online Application. If you do not have a PayPal account and would like to pay online, you can click on the PayPal link on the home page. Note: In order to pay online you do not need to have your license or Social Security Number online. Please download the form. Use Form DS-1054, “Registration Form for Youth Care Home Service” to: register each adult, legal guardian age 18-45 who is responsible for the care of a child age 6 or older, age 12 or older, or legal surrogate. Register each child, legal ward who is under age 12, who is not the legally responsible adult, age 13, and age 15. Register each child, guardian age 18-45 who is not the child's legal guardian age 18-45. Note: If the care is provided in a home or community-based setting, the person responsible for the child may be the owner or operator.

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