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Get Rex Assist Application 2012-2024

Work First) Strike Benefits from Union Funds Other 1 _____________________________ Other 2____________________________ Other 3____________________________ Other 4____________________________ Total Monthly Income Monthly Amount Monthly Expenses Monthly Amount $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rent and/or Mortgage Land Mortgage Property Tax Home/ Car / Fire Insurance Food Electricity Heat (gas, oil, wood, kerosene) Water/Sewer/Garbage Telephone Cable TV Internet Vehicle/Auto Payment Health .

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