Printed from: https://services.workandincome.govt.nz
Printed: 07 December 2024
Childcare providers should complete this form when there has been a change for a child in your service.
Changes include children who:
Please make sure you submit this form for only one family at a time.
Please note the questions in this form may change dynamically based on your answers to previous questions.
After you submit the form, you’ll see a confirmation page with all the info you entered. If you want to keep a copy, you can print that page or save it as a PDF using the browser’s print function.