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Get OK DHS 04AF010E 2012

       Income Gross monthly income        3. Take-home monthly income        Other income or benefits List other income or benefits such as Social Security benefits, adoption assistance payments, foster care payments, child support, Supplemental Nutrition Assistance Program (SNAP), or Temporary Assistance for Needy Families (TANF). Source of income Gross monthly income Take-home income        $             $                    $        .

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