Part I: parent information
Item 1, the name of the parent or legal guardian with a child in the provider's care, and Item 2, the name of the parent's VA center.
VA0730i
Change in Child Care Provider
- Agency
- VA
- Revision
- June 2014
- Fillable fields
- 49
- Pages
- 1
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form VA0730i: Change in Child Care Provider
VA Form VA0730i is the U.S. Department of Veterans Affairs Change in Child Care Provider form. It belongs to the VA Child Care Subsidy Program, which the form's Privacy Act statement ties to agency use of appropriated funds for child care costs for lower income Federal employees. It is a program form for employees and their child care providers, not a Veterans benefit application.
The form's instruction says to complete it each time you change your child care provider, and says the agency administrator of the Child Care Subsidy Program uses the information to verify licensure status. The form is one page: Part I identifies the parent, Part II the current and previous providers and the new provider's license, Part III each child enrolled, and Part IV is the provider's certification with the provider's and the employee's signatures.
You can fill out the PDF free in your browser on this page and download the result without an account.
What's on VA Form VA0730i
Part II: current and previous provider
Items 3 to 8 name the current and previous child care providers and their addresses, the type of provider (center based or family child care home) and the child care services: full-time, before school, after school, or before and after school care.
Part II: contact and license
Items 9 to 15 ask for the new provider's telephone number, the current provider's email address, whether the new provider is licensed, a tax identification number or Social Security number, the license number, the state that issued the license and the license expiration date.
Part III: child information
Whether a schedule of fees is attached and whether the provider completed the SF 3881, then each child enrolled with the enrollment date, whether the child receives any other subsidy, its source and amount, and the total weekly fee for the child.
Part IV: certification
The provider certifies the information is true and correct to the best of their knowledge, with a statement that making a false statement on the form is a Federal crime under United States Code 18, Section 1001.
Privacy Act and burden
The header cites Public Law 107-67 and Public Law 104-134, says disclosure is voluntary but that missing information may result in denial of the application, and estimates 10 minutes per response.
How to fill out VA Form VA0730i
- 1
Fill in Part I
Enter the name of the parent or legal guardian with a child in the provider's care and the name of the parent's VA center.
- 2
Add both providers
Complete Part II for the current and previous providers. The form says to check only one type of provider and only one type of child care service.
- 3
List each child
In Part III, list each child enrolled, last name first, with the enrollment date as MM/DD/YYYY. If the child receives another subsidy, the form says to complete its source and amount.
- 4
Collect the signatures
The provider prints a name in Item 16 and signs Item 17, the employee signs Item 18, and the date goes in Item 19.
- 5
Mail it to the program office
Send the completed form to the VA Child Care Subsidy Program Office (05CCSP) at the Washington, DC address the form prints.
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Where it goes
Mailing address
Department of Veterans Affairs, VA Child Care Subsidy Program Office (05CCSP), 810 Vermont Ave., NW, Washington, DC 20420.
When to send it
The form says to complete it each time you change your child care provider.
Burden comments only
The form gives the VA Clearance Officer (005E3) address for comments on the burden estimate and says DO NOT send requests for benefits to this address.
Edition
The PDF footer reads VA FORM JUN 2014 0730i, matching the June 2014 revision date on VA's page. It carries OMB Number 2900-0717 and a respondent burden of 10 minutes.
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Who completes VA Form VA0730i?
The form names who fills in, signs and receives it.
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Questions about Form VA0730i
What is VA Form VA0730i used for?
The form says to complete it each time you change your child care provider. The agency administrator of the VA Child Care Subsidy Program uses it to verify licensure status.
Who fills out VA Form VA0730i?
The parent or legal guardian in the VA Child Care Subsidy Program fills in the parent information, and the child care provider certifies and signs Part IV. Item 18 is the employee's signature.
Is VA Form VA0730i a Veterans benefit form?
No. The form's Privacy Act statement ties the program to child care costs for lower income Federal employees, and the form goes to the VA Child Care Subsidy Program Office.
Where do I mail VA Form VA0730i?
The form lists Department of Veterans Affairs, VA Child Care Subsidy Program Office (05CCSP), 810 Vermont Ave., NW, Washington, DC 20420.
What license details does the form ask for?
Part II asks whether the new provider is licensed, the provider's tax identification number or Social Security number, the license number, the state that issued the license and the license expiration date.
Is giving the requested information voluntary?
The Privacy Act statement says disclosure is voluntary, but that failure to provide all of the requested information may result in denial of your application.