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WEEKLY X 52 Persons with disabilities who require alternative means of communication for program information e.g. Braille large print audiotape American Sign Language etc. should contact the Agency State or local where they applied for bene ts. My signature below authorizes the release of information on this application for textbook assistance. I give up my right of confidentiality for this purpose only. This ap plication information will be shared with the Indiana Family and Social Services...
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