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State of Illinois Department of Human Services Bureau of Child Care and Development NOTICE OF CANCELLATION FOR CHILD CARE PAYMENTS Parent/Guardian: Provider: Child Care Case #: Date of Notice: Caseload
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How to fill out notice of cancellation for:

01
Begin by stating your intention to cancel. Clearly state the reason for cancellation and any relevant details such as the date of the original agreement or contract.
02
Provide all necessary information about the agreement or contract being cancelled. Include the names of all parties involved, the date of the agreement, and any specific terms or conditions that are relevant to the cancellation.
03
Make sure to include contact information for yourself or your company, including your full name, address, phone number, and email address. This will allow the recipient to reach out to you if they have any questions or need further information.

Who needs notice of cancellation for:

01
Individuals who have entered into agreements or contracts that they wish to cancel.
02
Businesses or organizations that want to terminate contracts or agreements with other parties.
03
Anyone who wants to formally document the cancellation of an agreement or contract for legal or record-keeping purposes.
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The notice of cancellation is for informing the necessary parties about the cancellation of a specific event or service.
The individual or organization who is responsible for the event or service being cancelled is required to file the notice of cancellation.
To fill out a notice of cancellation, one must provide details about the event or service being cancelled, the reason for cancellation, and any relevant dates.
The purpose of the notice of cancellation is to officially communicate the decision to cancel the event or service to all relevant parties.
The notice of cancellation must include information such as the name of the event or service, the date of cancellation, the reason for cancellation, and contact information for further inquiries.
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Illinois IL444-4178 R-3-11 Caseload CANCELLATION Provider

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