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Get MN DHS-7122-ENG 2020-2024

In Section 2) use this form to confirm that a person meets certain criteria for one or both of the following: Medical Assistance Housing Stabilization Services Minnesota Housing Support Program After completing this form, please return to the person or their authorized representative. This request does not represent an offer of payment on the part of the state, county, or tribe. Do you authorize the Qualified Professional to release your information? (read and sign below) I give permissi.

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