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Get Benefits Appeal 2013-2024

Eck all that apply: Do you want this person to have an EBT card to buy food for you? U.S. Citizen/National ■ Noncitizen ■ Legal Permanent Resident Sponsored: Do you buy and prepare food with this person? NAME: SSN: DATE OF BIRTH: ■ ■ ■ Check all that apply: Do you want this person to have an EBT card to buy food for you? U.S. Citizen/National ■ Noncitizen ■ Legal Permanent Resident Sponsored: Do you buy and prepare food with this person? NAME: SSN: DATE OF BIRTH: ■ ■ ■ Ch.

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