Proof of relationship with the child(ren) (i.e., Proof that you’re the Child(ren)’s grandparent, great-grandparent, great aunt, great uncle, adult brother, sister, aunt, uncle, niece, nephew, or cousin). Proof of relationship is two-fold. First the caregiver must prove a relationship between themselves and the parent and, second, a relationship between the parent and the child to whom the subsidy will be granted. Proof of the relationship is by one or more of the following:

• Birth certificate or decree of adoption

• Court determination of paternity

• Acknowledgement of Paternity (AOP)

• Child Support Agreement or Court Order

• Proof that parents were married at time of child’s conception or birth

• Marriage certificate or proof of common law marriage

• DNA test results

Proof that you are the child(ren)’s primary caregiver by one of the following:

• A court order, signed by a judge, granting you custody of the child; or

• A court order, signed by a judge, granting you standby guardianship of the child, pursuant to D.C. Code §§ 16-4801–4810; or

• A decree, signed by a judge, stating that you have adopted the child.

If you do not have any of the above documents, you may still qualify by providing one of the following:

• Records showing that you enrolled the child in school the most recent school year or that you are the primary educational contact for the child; or

• Immunizations or medical records, no more than two years old, indicating that you are tending to the child’s medical needs; or

• Proof that you have received either SSI or TANF for the child; or

• A letter from any legal, medical, military, law enforcement, social service or similar professional, or your landlord describing your status in caring for the child.

• AND stating why the parents are unable to care for the child(ren)

Proof that you applied for TANF benefits on behalf of the child(ren) through the District of Columbia Department of Human Services.

• The amount of a subsidy a caregiver is eligible to receive shall be offset by any amount a caregiver receives as TANF for the child.

Note: For the Grandparent Caregiver Program, you will be required to provide proof that an eligibility determination has been made prior to being approved for a subsidy.

Proof of residence by providing the following documents:

• Driver’s license or Government-issued ID AND

• A copy of a lease or mortgage

Proof of household income (i.e., proof of the income of every individual who resides in my house). For proof of income, we will only accept:

• A tax return no more than one year old

• Three most recent pay stubs

• Social security, annuity, or retirement statements and W2 forms

• If you are claiming that you have no income and cannot provide one of the approved forms for proof, you will be provided and will submit a sworn statement called an ‘Affidavit of No Income’.

Note: The household income must be below 200 percent of the federal poverty level.

After submitting the online application, all adults (anyone 18 years or older) must complete both the Child Protection Register check and the FBI/local police clearance. You will be provided instructions on:

• Completing an application for a Child Protection Register check for each adult who resides in your home.

• Scheduling an appointment for fingerprinting at our office to conduct an FBI and local police clearance.

Note: The caregiver and all adults residing in the home who have submitted to both a criminal background and a Child Protection Register check must be “cleared”, or an exception made to be eligible for the subsidy.