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APPLICANT\'S INFORMATION Applicant\'s Name (First Name)(Middle Name)(Last Name)Date of Birthplace of BirthPreferred Move in Date:Applicant\'s Email Note: Applicant must be 19 in the State of Nebraska.

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The first name of the applicant is required in the applicant information.

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The applicant themselves or their authorized representative must fill out the applicant information with their first name.

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Only the first name of the applicant needs to be reported in the applicant information.