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ResetNYCHA 015.015 (Rev. 6/06)NEW YORK CITY HOUSING AUTHORITYLEAVE OF ABSENCE REQUESTEMPLOYEE INFORMATION EMPLOYEE\'S NAME (Print)EMPLOYEE ID #EMPLOYEE\'S TITLEDEPARTMENT/DIVISION OR DEVELOPMENTDATEIf
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Provide any necessary identification information, such as your social security number or driver's license number.
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015 rev may be needed by individuals or organizations who are required to report specific financial information as mandated by tax laws or regulatory entities.
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