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Get Nycha Form 040 012

This form shall be made available to and used by all job applicants and employees requesting a reasonable accommodation in accordance with NYCHA s INSTRUCTIONS Where necessary or requested NYCHA supervisory staff the Human Resources Placement and Certification Coordinator Interviewer and/or the Employee Reasonable Accommodation Coordinator ERAC shall assist applicants or employees in completing this form. Job applicants - Complete Sections I and .

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