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Get the free APPLICANT'S SUPPLEMENTAL STATEMENT OF FACTS FOR MEDI-CAL, FORM MC 223 (9/85 REVISION)

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GEORGE DEUKMEJIAN, GovernorSTATE OF CALIFORNIAHEALTH AND WELFARE AGENCYDEPARTMENT OF HEALTH SERVICES 714/744 P STREETSACRAMENTO, CA95814February 25 1986TO:All County Welfare Directors County Administrative
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Note: It is essential to carefully read the specific instructions provided for the supplemental statement as requirements may vary depending on the purpose and context of the application.

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It is important to consult the application guidelines or contact the relevant authority to determine if an applicant's supplemental statement is required for your particular situation.
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The applicant's supplemental statement is a document that provides additional information or clarification related to an application, typically required in a legal or administrative context.
Individuals or organizations submitting certain types of applications, particularly in legal, regulatory, or government contexts, are required to file an applicant's supplemental statement.
To fill out the applicant's supplemental statement, carefully read the instructions provided, provide accurate answers to all required questions, and ensure that all necessary documents or forms are attached.
The purpose of the applicant's supplemental statement is to provide additional context or information that supports the application, ensuring clarity and completeness for the reviewing authority.
The information required on the applicant's supplemental statement varies by context but typically includes detailed explanations, clarifications, or additional documents relevant to the application.
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