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AM 210 APP LIC ACTION FORM I. PERSONAL DATA Please put your picture here. NAME Last First Middle SOCIAL SECURITY # DATE OF BIRTH Month Day Year PLACE OF BIRTH City Country OF CITIZENSHIP HOME PHONE
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AM210 applicationindd is a form used for applying for a specific program or benefit.
Anyone who meets the eligibility criteria for the program or benefit outlined in the form.
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The purpose is to apply for a specific program or benefit outlined in the form.
Information such as personal details, eligibility criteria, and supporting documents may need to be reported.
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