WAGE VERIFICATION IL444-3514 JOB INFORMATION: TO BE COMPLETED BY YOUR EMPLOYER ONLY Employee PLEASE RETURN FORM TO:
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WAGE VERIFICATION IL444-3514 JOB INFORMATION: TO BE COMPLETED BY YOUR EMPLOYER ONLY Employee PLEASE RETURN FORM TO:
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State of Illinois
Department of Human Services - Bureau of Child Care and DevelopmentWAGE VERIFICATION
IL444-3514 (N-1-11)
Page 1 of 1
I hereby authorize my employer to release the following information to �the Illinois Department of Human Services.
I understand that this information may be verified by phone. Any fraud�ulent, false or misleading information given
may result in loss of childcare payments and my child care case may be �cancelled or denied.