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Public Assistance To mm/yyyy Cash assistance Welfare Medical assistance Food Stamps SSI Form I-643 Rev. 10/16/08 Y. Data Unit Office of Refugee Resettlement 370 L Enfant Promenade S.W. 6th Floor Washington DC 20447 Print or type in black ink. OMB No 1615-0070 Expires 09/30/09 Department of Homeland Security U.S. Citizenship and Immigration Services What Is the Purpose of This Form Refugees and asylees Cuban/Haitian Entrants under the Act of November 1 1996 and Amerasians under Public Law...
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OMB No 1615-0070 expires is needed by individuals or organizations who are required by the agency to provide certain information. The specific requirements and purposes can vary depending on the agency and the nature of the information being requested.
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OMB No. 1615-0070 expires on 08/31/2024.
Individuals or entities specified by the Office of Management and Budget (OMB) are required to file OMB No. 1615-0070.
OMB No. 1615-0070 can be filled out electronically or by following the instructions provided by the OMB.
The purpose of OMB No. 1615-0070 is to collect specific information as required by the OMB.
The specific information required to be reported on OMB No. 1615-0070 varies depending on the instructions provided by the OMB.
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