Change Request

Child Care Assistance Change Notification

PRIM ID

TWIST ID*

Your TWIST ID will be located on any paperwork provided to you by the Tarrant County CCMS office and will be used to identify your records. This number is issued to you by the Texas Workforce Commission.

Last 4 of SSN (Optional)

Alternatively, if you do not have your TWIST ID, you may enter the last four digits of your SSN so we can identify your records.

Name*

First Last

Date of Birth*

Contact Phone*

Email*

Enter Email Confirm Email

Item that needs to be changed or updated*

Information Type*

Physical Address
Mailing Address
Home Phone
Cell Number
Email Address

Mailing Address*

Street Address City ZIP Code

Physical Address*

Street Address City ZIP Code

Home Phone*

Cell Phone*

New Email*

Income Change Type*

Increase of Income
Decrease of Income
Additional Income
Loss of Employment

Add Children / Relationship Changes

Effective Date*

Hourly Rate*

Number of Hours Per Week*

Start Date*

Employer Name*

Work Schedule*

School Name*

School Schedule*

School Start Date*

School End Date/Expected Graduation

Drop or Suspend*

Drop from CCMS Program
Suspend Care

Child's Name*

Daycare Name*

Ending Child Care Date*

Reason For Dropping/Suspending/End Date Change*

Parent Change Request

Child Care Assistance Change Notification