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RECEIPT FOR CHILD DAY CARE SERVICES Provider/Business Name:_________________________________ Date Received: ___________________ Received from: ___________________________________________________________________ Amount:
$__________________________Paid
by: Check #____________________Cash____________ For Child Care Services from:_________________________ To____________________________________ ______________________________________________________________Provider Signature ________Date ______________________________________________________________Parent Signature _________Date
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RECEIPT FOR CHILD DAY CARE SERVICES Provider/Business Name:_________________________________ Date Received: ___________________ Received from: ___________________________________________________________________ Amount: $__________________________Paid by: Check #____________________Cash____________ For Child Care Services from:_________________________ To____________________________________ Balance Due:_______________________________________________________________________________ ______________________________________________________________Provider Signature ________Date ______________________________________________________________Parent Signature _________Date
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