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Get GA 508 2014

His section only if you want someone to fill out your application/renewal, complete your interview for Food Stamps or TANF, and/or use your Food Stamp EBT card to buy food when you cannot go to the store. If you are applying for Medicaid, you can choose more than one person to apply for medical assistance on your behalf. Name: ___________________________________________ Phone: __________________________________ Address: ___________________________________________ Apt: _____________________.

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