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Connecticut Department of Children and Families
VERIFICATION OF REQUIREMENTS FOR LICENSURE
DCF043
6/17 (Rev.) Page 1 of 4Parent #1
FIRST Name:LAST Name:Parent #2
FIRST Name:LAST Name:DOB:Home Phone:DOB:Home
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01
To fill out verification of requirements, follow these steps:
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04
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Keep a copy of the submitted verification form and documents for personal records.
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