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PRINT NAME DATE SIGNED yyyy/mmm/dd SPOUSE S SIGNATURE CF2568 12/07 Forms can be obtained at one of the following www. CHILD CARE SUBSIDY SELF-EMPLOYMENT The personal information collected on this form is under the authority of the Child Care Subsidy Act. The information will be used to determine eligibility for child care subsidy. Personal information is protected from unauthorized use and disclosure in accordance with the Freedom of Information and Protection of Privacy Act. If you have any...