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PDF created with pdfFactory trial version www. pdffactory. com RENTAL INFORMATION Current rent / Month How long have you resided at this address Years Months What utilities are your responsible to pay for Do you receive rental assistance q No q Yes Please check the type of rental assistance you receive. CITY OF SALEM DEPARTMENT OF PLANNING AND COMMUNITY DEVELOPMENT KIMBERLEY DRISCOLL MAYOR 120 WASHINGTON STREET SALEM MASSACHUSETTS 01970 TEL 978-619-5685 FAX 978-740-0404 LYNN GOONIN DUNCAN...

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