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Irene Fake
INVOICE
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Behaviour Interventionist
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1234 56th AveDATE:01-Aug-2011
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Vancouver, BC V1N N1N
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Invoice #1
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Client Name (Child):Jon Jones
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BILL TO:
PAYMENT DUE:
10-Aug-11
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Autism Funding Unit
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Ministry of Children and Family Development
Billing # (from AFU)
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PO Box 9776 STN PROV GOVT
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Victoria BC V8W 9S5
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Fax: 250-356-8578
Email: mcf.autismfundingunit@gov.bc.ca
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Date of ServiceDescription of ServiceHoursHourly RateAmount
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01 January 2012Behaviour Intervention2.00$10.00$20.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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$0.00
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TOTAL $20.00
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Make all cheques payable to Irene Fake
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_______________________Signature of Parent (if required)
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