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Apply for Dependent Care Voucher

Please complete the application form and mail or hand carry it to the Office of Work, Life and Engagement, 1101 E. 33rd St., Suite C100, Baltimore, MD 21218. We must have the signed original for our files so you may not email or fax the completed form.

Application Form

A completed application must include:

  • Original signature on the application
  • Original signature on the Policies and Procedures page
    Policies and Procedures
  • Copy of your most current, complete, and signed federal 1040 tax form
    • If you and your spouse/partner file separately, both tax statements  must be attached.
  • Original signature on the completed Provider Enrollment form
  • Photocopy of the provider's state license
  • A copy of your child's certified birth certificate
  • Copy of marriage certificate, affidavit of marriage, or affidavit of domestic partnership (adult care only)


  • When all materials are received, we will verify eligibility. If you are within guidelines, you will be notified of approval or wait list status as soon as the necessary paperwork and verifications are completed.
  • You will be ineligible for the Dependent Care Voucher program if you have reached the $5,000 limit for employer sponsored dependent care assistance. You can reapply the following year if you decrease the amount of money in your Dependent Care Flexible Spending Account for the upcoming year.
  • If available university funds are spent, a waiting list will be maintained. As additional funds become available, employees on the list will be awarded assistance. Participants in the Dependent Care Voucher program during the previous year who maintain their employment eligibility and submit current 1040 tax forms will have priority over new, qualifying applicants.
  • Adjustments will be made in the subsequent award period, if an over-payment resulted. The amount of the over-payment will be subtracted from the next voucher program check, or you will be responsible for reimbursing the Dependent Care Voucher program directly. Should you resign or be terminated from the university, adjustments and overpayments will be deducted from your final check.
  • Applications are dated as they are received and processed on a first come, first served basis throughout the year as funds allow.



Maximum Dependent Care Benefit

The maximum dependent care benefit is $5,000 annually. Five thousand dollars ($5,000) is the combined total allowed by the Internal Revenue Service (IRS) per family, per calendar year for employer sponsored dependent care assistance. Employees who enroll for the maximum amount in their Dependent Care Flexible Spending Account are not eligible for a subsidy, but they are welcome to utilize the Backup Care program. You are responsible for making sure that the combined total of dependent care benefits does not exceed $5,000.

Updated 10/20/2014