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Get NY LDSS-3421 2017

Ituation _______________________________ MY MONTHLY RENT OR MORTGAGE PAYMENT IS: RENTER  Private House, Apartment or Mobile Home SUBSIDIZED RENT  Private Subsidized Housing  Public Housing Project or Senior Housing  Public Subsidized Housing Do you receive a HUD utility allowance?  Yes If yes, how much $___________ $ ________________________  No  NONE IF APPLICABLE, THE NAME OF THE APARTMENT BUILDING OR HOUSING PROJECT I LIVE IN IS: ___________________________________ D.

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