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Tet Telefon (Angabe freiwillig) getrennt lebend Fax (Angabe freiwillig) geschieden verwitwet eingetragene Lebenspartnerschaft (bitte Zutreffendes ankreuzen) Ich erhalte Leistungen zur Sicherung des Lebensunterhaltes/Sozialgeld bzw. Regelleistungen nach dem SGB II oder im Rahmen der Kriegsopferf rsorge nach dem Bundesversorgungsgesetz oder nach dem Gesetz ber eine bedarfsorientierte Grundsicherung im Alter und bei Erwerbsminderung. (Ein Nachweis ber den Bezug der Leistung ist bitte vo.

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