Childcare Expense Report

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I. General Information

Reporting Period:


Children:

Child's Full Name

Date of Birth

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Care Provider Full Name:


Care Provider Contact Information:

Phone Number:

Email:


Address:


Care Provider License Number:

Tax Identification Number/EIN of Provider:


II. Attendance and Schedule

Days of the Week Care Provided:


Hours of Care:

Start Time:

End Time:


Number of Weeks:

Number of Months:


Were there any absences?


Were there any variations in the regular schedule?


III. Expenses

Tuition/Fees:

Payment Date

Frequency (Weekly, Monthly, etc.)

Notes

Amount

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Total:
 
 
$0.00

Registration Fees:

Payment Date

Description

Amount

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Total:
 
$0.00

Supply Fees:

Payment Date

Description

Amount

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Total:
 
$0.00

Late Fees:

Date of Late Pickup

Date Paid

Reason

Amount

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Total:
 
 
$0.00

Other Fees:

Payment Date

Description

Amount

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Total:
 
$0.00

Grand Total Expenses:

$0.00

Payment Method:


Other Payment Information:

Payment Date

Amount Paid

Receipt Attached? Tick if Yes

Receipt Attachment

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

IV. Tax Information

Is the care provider a qualified individual or organization?


Did you receive a Form W-10?


V. Additional Information

Reason for Care:

Percentage of Time Spent in Care:


Subsidies and Financial Assistance:

Source

Description

Amount

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Form Template Instructions

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This Childcare Expense Report form is designed to capture comprehensive information about childcare costs, attendance, and related details. It's structured to be useful for various purposes, including:

  • Personal Record-Keeping: Tracking your childcare expenses for budgeting and financial planning.
  • Tax Preparation: Providing the necessary information to claim childcare-related tax credits or deductions (in applicable jurisdictions).
  • Reimbursement Requests: Submitting documentation for reimbursement from an employer, government program, or other source.
  • Subsidy Applications: Providing supporting documentation for childcare subsidy applications.

Here's a breakdown of each section and its importance:


I. General Information: This section establishes the context for the report.

  • Reporting Period: Defines the timeframe the report covers, ensuring clarity and organization.
  • Child's Name(s) and Date(s) of Birth: Essential for identifying the child(ren) receiving care, especially if multiple children are involved. Date of birth is often needed for tax purposes.
  • Care Provider Information: Crucial for identifying the childcare provider, especially for tax purposes (you'll likely need their tax ID or EIN). Contact information is also important for communication. License numbers are often required for tax credits or certain subsidy programs.

II. Attendance and Schedule: This section details the childcare arrangement.

  • Days of the Week Care Provided: Helps determine the total cost and is useful for tracking attendance patterns.
  • Hours of Care: Essential for calculating costs, especially if billing is hourly. Also relevant for determining eligibility for some programs.
  • Number of Weeks/Months Care Provided: Provides a summary of the duration of care within the reporting period, useful for calculating total expenses.
  • Absences: Important for reconciling billing, as some providers may charge for absences. The excused/unexcused distinction may also be relevant.
  • Schedule Variations: Captures any deviations from the regular schedule, which could affect billing or be important for record-keeping.

III. Expenses: This is the core of the report, detailing all childcare-related costs.

  • Tuition/Fees: The regular cost of care, whether weekly, monthly, or otherwise. Specifying the frequency is crucial.
  • Registration, Supply, Late, and Other Fees: Captures all additional expenses associated with childcare. "Other Fees" allows for itemizing less common costs (field trips, events, etc.).
  • Total Expenses: The sum of all childcare costs for the reporting period. This is the key figure for tax purposes and reimbursements.
  • Payment Method and Dates: Provides a record of how and when payments were made, which is important for reconciling expenses and tracking payments.
  • Receipts Provided?: Indicates whether supporting documentation (receipts) is included. Always keep receipts as they are essential for tax purposes and reimbursements.

IV. Tax-Related Information: This section gathers information needed for tax purposes.

  • Qualified Provider: Determines eligibility for certain tax credits or deductions. The IRS has specific definitions of what constitutes a "qualified" provider.
  • Form W-10: This form, completed by the provider, provides the necessary information for you to claim the childcare tax credit.

V. Optional Information: This section collects additional details that may be relevant for specific purposes.

  • Reason for Care: May be required for certain subsidy programs or for internal tracking.
  • Percentage of Time Spent in Care: Relevant if the child attends part-time, as some programs or calculations may be based on this.
  • Subsidies/Financial Assistance: Important for understanding the true net cost of childcare and for reporting purposes.

Overall Insights:

This form is well-structured and comprehensive. By collecting this information, you can effectively manage your childcare expenses, prepare for taxes, and potentially access financial assistance. The level of detail required in each section highlights the importance of keeping thorough records throughout the year.

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