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Get VA Affordable Housing Application - Norfolk

____________________________ (First) (Middle) (Last) Social Security Number ______-_____-______ Mailing Address __________________________________________________________________________ (Street Name or PO Box Number) _____________________________________________________________ (City) (State) (Zip Code) Home Number (______) _______- _______ Cell Number (______) _______- _______ Date of Birth ____/____/_____ Sex MM /DD/ YYYY HUD Household Type (Please Check One)  Disabled  Elderly .

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