RC64 Children's Special Allowances

Children's agencies use this form to apply for or to cancel Children's Special Allowances (CSA).

Ways to get the form

• Download and fill out with Acrobat Reader

  You must download and open fillable PDFs in Acrobat Reader 10 or higher.

  • Accessible Fillable PDF (rc64-fill-23e.pdf)

• Print and fill out by hand

  • Standard print PDF (rc64-23e.pdf)

• Ask for an alternate format

  You can order alternate formats such as digital audio, electronic text, braille, and large print.

  • Order alternate formats for persons with disabilities