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DASHED 863 Rev. 09/2012 State of Utah Department of Workforce Services REQUEST FOR MORATORIUM ON UTILITY SHUT-OFF Date: Applicant Name: Applicant Address: City: Utility Account Holder's Name (if different):
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What is dws-hcd 863 rev?
Dws-hcd 863 rev is a form used for reporting certain information to the relevant authorities.
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All eligible individuals and entities are required to file dws-hcd 863 rev.
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