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Booth bay Harbor Town/City of ___03/24/17APPLICATION FOR GENERAL ASSISTANCE Administrator: Please read the following to the applicant or have the applicant read it in your presence. PENALTY FOR FALSE

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Whoever knowingly and willfully refers to someone who is aware of their actions and intentionally commits a specific act.

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The report on whoever knowingly and willfully must include details about the act committed, the individual responsible, and any other relevant information.

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