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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your Foster Home Name, Address, City, State, Zip, and Phone Number in the designated fields.
- Fill in the Month/Year and County information accurately to ensure proper processing.
- For each child listed, provide their Name, TWIST #, Entry Date, DOB, Exit Date (if applicable), # of Days in care, Rate per day, and Total amount due.
- Complete the Totals section by summing up amounts from each category: Board, Special Expense, and Training Expense. Ensure all calculations are correct.
- Sign and date the form at the bottom to certify that all information is accurate and complete.
- Attach any required receipts for training expenses or special expenses as noted in the instructions.
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