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Las Vegas Urban League Child Care Subsidy Program 2470 N Decatur Blvd Suite 150 Las Vegas NV 89108 702-629-2561 Fax 702-629-6232 Service Month Service Year Bill Annual Fee Bill Registration Fee Child Care Enrollment Attendance Verification EAV Form PLEASE DO NOT USE WHITE OUT Provider Name Provider Tax ID or SSN Provider Address City Zip Parent Name Child Track DATE On Track Child DOB Overnight Child Name Is the client s co-payment current Provider s Initials TIME IN TIME OUT Yes Phone Child UPI or SSN Child School Hours No Parent Signature for Authorization of Discretionary Day If NO balance due Please attach a record of monies owed by client The timesheet must be completed DAILY by the client or other authorized individual. If a client chooses to use a discretionary day the client must sign in the space provided for that date. A separate timesheet must be completed for EACH child. Timesheets must be COMPLETED and SIGNED by both the CLIENT AND PROVIDER at the end of each month to rece....

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Eav Online Attendance
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2016 NV Las Vegas Urban League Child Care Enrollment Attendance Verification (EAV) Form
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