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Get Request For Child Care Services Form

Iling address, provider 10-digit ID, county, and phone number must be included in the space provided. If an adjustment is authorized, reimbursement cannot be issued without this information. Requests without provider 10-digit ID cannot be processed and will be returned to the child care facility. The provider 10-Digit ID begins with the number five (5) and if found on the Provider Notice of Registration. 4. STATUTE OF LIMITATIONS: The request form must be received in the Child Care Services Divi.

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