Page 1S60W – JUL 2015
Online payment schedule
email request form
If you are a childcare centre or OSCAR provider, you can use this form to add, change or cancel your
email address for receiving payment schedules each week.
• Add – means you are asking to receive your payment schedules by email
• Change – means we will send schedules to a new email address you provide
• Cancel – means we will stop sending you schedules by email and instead you will get them by post.
If you run more than one centre or programme, you’ll need to complete a separate form for each.
Tell us your
request
HOW TO ANSWER Q2
:
This needs to match
the name on the
first page of your
hardcopy payment
schedule.
HOW TO ANSWER Q4
:
This is on the second
page top right-hand
corner of your
hardcopy payment
schedule.
What do you want to do?
Add an email address Change an email address
Cancel an email address
What is the programme/centre’s name?
What is the programme/centre’s email address?
What is the programme/centre’s social welfare number?
If you are changing email address, what is the new email address?
Declaration
I am authorised by this childcare centre or OSCAR provider to complete this form.
The information I have provided is true and complete.
Your name Date
Day Month Year
Business address
Business postal address
Once completed, save this form then email it to centralised_childcare_reviews@msd.govt.nz
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