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DATE SIGNATURE OF APPLICANT SIGNATURE OF SPOUSE If applicable INCOME VERIFICATION STATEMENT APPLICANT DATE APPLICATNS SOCIAL SECURITY NO. XXX-XX- The Gadii ahi/To koi Chapter is requesting your assistance to verify income information for the abovenamed applicant who is applying for Housing Discretionary Funds. The land is possessed pursuant to a Leasehold Interest Use Permit Indefinite Assignment or Joint Ownership as Described ADDITIONAL QUESTIONS 1. GADII AHI/TO KOI CHAPTER GOVERNMENT...
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