| I certify that the income provided is accurate. (Initials) | https://wha-hss.wpmgjobs.com/index.php?gf-signature=67fdb9d6c27107.13879164&form-id=5&field-id=325&hash=5b91cf75ed9f75cabfda4f25e40221d334ee1bc26ee308483cf85b80807cb663
| https://wha-hss.wpmgjobs.com/index.php?gf-signature=681be8f4666ba7.62583657&form-id=5&field-id=325&hash=f4d5452f4ffdc668874ef1668016a90ac194f03967cab6fe0ede09fc7fdadcc0
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| Applicant Signature | https://wha-hss.wpmgjobs.com/index.php?gf-signature=67fdb9d70f83e9.13257043&form-id=5&field-id=265&hash=27c703009b53eeabc3e38d15cccf9b1b58c72f3b21c6bc043db9c2ae76d4f6b0
| https://wha-hss.wpmgjobs.com/index.php?gf-signature=681be8f4d9d792.37130624&form-id=5&field-id=265&hash=eacf66367f62d105fb55fc53dc82224cb47d41193bde29e395ef8d0376ae6c13
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| Initials | https://wha-hss.wpmgjobs.com/index.php?gf-signature=68011f52ede021.01257121&form-id=5&field-id=328&hash=6e4110d7e3a3de5dd14eab9d4e8324231e7bfd9e9c7ba381f38ab123206841b1
| https://wha-hss.wpmgjobs.com/index.php?gf-signature=681be8f51efef3.26725049&form-id=5&field-id=328&hash=5289d186e1338025cb51f03573b53553b3054295d3ddea9723b4716e8678ef3c
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| Please briefly explain why you are unable to provide the required documentation. | No Value | I'm currently waiting for disability claim to go through I'm homeless and have no job or income to prove |
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| Applicant Signature | No Value | https://wha-hss.wpmgjobs.com/index.php?gf-signature=681be8f49f5969.18245745&form-id=5&field-id=238&hash=b75660905be1b43dc9bc97948a63477ac50d88ca6a7b9fdb2f10c1f8d1ce053d |
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| Date | No Value | 2025-05-07 |
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