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ASSET TRANSFER UNDUE HARDSHIP CLAIM FORM Return To: Agency: Address: Case Name: Case #: Worker Name: Worker Telephone #: The opportunity to claim an Undue Hardship must be offered when the imposition
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Individuals applying for benefits or assistance offered by the Virginia Department of Social Services (DSS).
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Anyone seeking information or support related to social services provided by the state of Virginia may find this form useful to understand the application process and requirements.
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