Child Day Care Licensing – Initial Application Fee Invoice Form
Phone: (860) 509-8045, Fax: (860) 509-7541
Telephone Device for the Deaf (860) 509-7191
410 Capitol Avenue - MS # 12DAC
P.O. Box 340308, Hartford, CT 06134
An Equal Opportunity Employer
The licensing fee along with this Initial Application Fee Invoice Form is due with your application to obtain a child day care license. THE FEE IS NON-REFUNDABLE.
Please complete items 1 through 9 of this form. If you have questions, call the licensing office at 1-800-282-6063 or (860) 509-8045. Make your payment by check or money order payable to: TREASURER-STATE OF CONNECTICUT. Mail this form along with your payment and application to the Department of Public Health at the address on the bottom of this form. 
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