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Form Approved OMB No. 09600124SOCIAL SECURITY ADMINISTRATION. O. Restatement OF INCOME AND RESOURCESName of Applicant/Recipient am/We are providing this statement on behalf of to determine his/her
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To fill out the name of the applicant/recipient, follow these steps:
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Start by writing the full name of the applicant/recipient in the designated space.
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Make sure to include the first name, middle name (if applicable), and last name.
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Use capital letters for the first letter of each name.
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Avoid using any titles or honorifics, like Mr., Mrs., or Dr.
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If there are multiple applicants/recipients, provide the name of each person separately or as instructed.

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The name of the applicantrecipient is the entity or individual who is applying or receiving the funds.
The entity or individual who is managing or distributing the funds is required to provide the name of the applicantrecipient.
To fill out the name of the applicantrecipient, simply write down the full legal name of the entity or individual.
The purpose of the name of applicantrecipient is to accurately identify the entity or individual who is applying for or receiving the funds.
The information that must be reported on name of applicantrecipient includes the full legal name, address, and contact information of the entity or individual.
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