← Back to Cortland County, NY

Document cortlandcountyny_gov_doc_b01e05a5de

Full Text

CORTLAND COUNTY CHILD’S NAME DEPARTMENT OF SOCIAL SERVICES MONTH OF FOSTER PARENT DAYCARE SHEET CASE NUMBER DATES *REASON FOR DAYCARE TIME FROM TIME TO TOTAL HOURS $2.10 PER HOUR DAYCARE PROVIDER SIGNATURE *work, training, medical, etc TOTAL Please submit daycare sheets for reimbursement within 90 days of rendering the services or payment will not be made. Foster Parent Signature Supervisor Signature Caseworker Signature Director Signature