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Get IA DHS 470-2881 2014

Cting to go to jail or prison? Yes No Has anyone been disqualified from a Food Assistance program in any state for fraud or a program violation? Yes No Income Send proof – Send all pay stubs or proof of income for the last 30 days. For proof of tips, send pay stubs showing tips, employer’s statement, or your tip records. For new jobs, send proof showing first pay date, hourly rate, and weekly number of hours. If job stopped, send proof of the date of the last pay. You must tell us abo.

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