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: (EDC): Sec/Unit expected: Case Name Application Date Case Number CS/OV/TC Retromedical? 8010 sent? Relationship (if applicable) BASIC ELIGIBILITY REQUIREMENTS How Verified HH Member/ Relationship (Specified relative/ Essential person) (PI) Residency U.S. Citizen/ U.S. National Alien Status/ DOE/Sponsored? Photo ID DOB SSN Assets Unearned/Earned Income Childcare Expense(s) TPL(s) Type/ Effective Date/ Policy/Claim # Medicare / Effective.

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