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Child care fees. ROUTINE USE(S): None. DISCLOSURE: Voluntary; however, failure to furnish information will result in placement in the highest fee range. 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 y.

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