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Get In Form 56907 2020-2024

Equired documentation will result in termination of child care benefits without notice. Please use application checklist provided to assist in preparation of worksheet for mailing. The income and residency documentation you submit must be dated no earlier than thirty (30) days before the date you sign this worksheet. Name of parent / applicant Automated Inquiry System (AIS) number Date of birth of parent / applicant (month, day, year) Home telephone number Other telephone / contact number (.

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  • MISREPRESENTATION
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