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OMB NO. 18200030 Expires: 01/31/2026 ANNUAL STATE APPLICATION UNDER PART B OF INDIVIDUALS WITH DISABILITIES EDUCATION ACT AS AMENDED IN 2004FOR FEDERAL FISCAL YEAR 2023 CODA No. 84.027A and 84.173A
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Obtain the eligibility documents from the appropriate authority.
02
Read the instructions carefully to understand the requirements.
03
Fill out the necessary personal information accurately.
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06
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Who needs eligibility documents for part?

01
Individuals who are applying for a specific program or service that requires proof of eligibility.

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