Tax Receipt

Daycare Name
Daycare Address
Ottawa, Ontario
K1K 2K2
To:
Address:
City/Province:
Postal Code:
Phone #:
I here by declare that as a childcare provider I have received the amount of
$__________ from _______________________________ for childcare. These fees were paid
during the tax year of ____________ for the child named
_______________________________.

Fee Breakdown
Pay Day

Amount Paid

Fees Paid For

Date paid

$400

DCP

Date paid

$400

DCP

Date paid

$400

DCP

$1,200

Providers Full Name: ________________________________________

Date: ___________________
Please Note: Providers SIN number will be provided to Canada Revenue upon request, by Canada Revenue.

Legend

LF = Late Payment Fee

Bounced Check Fee
AF = Administration Fee
Reimbursement Fee
OF = Other Fee

LPF = Late Pickup Fee

HF = Holding Fee

NFS = NFS Check Fee

DT = Deposit Fee

DCP = Daycare Enrollment Fee

BC =
RF =