Get And Sign Dd 2652 Form

SECTION I - DEPENDENT CHILDREN To determine child care fees for your child ren or any child ren you legally claim as your dependent s you must complete sign and return this form to the director of the program you are applying for. Fees will be determined based on your total family income as defined below. If you do not wish to disclose your total family income your rate will be set automatically at the highest fee level* 1. NAME OF EACH CHILD 2. DATE OF BIRTH LAST First Middle Initial YYYYMMDD...