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Get CA CW 42 2016

E the payment made out to you or given directly to a shelter, landlord or other for you. Check (✓) below to tell us how you want the payment made: ■ To Yourself ■ To a Landlord ■ To a Shelter Disposition: ■ Shelter arranged prior to TS ■ ■ ■ Vendor payment issued HA denied Other (explain): If you do not have a permanent home, fill out questions 8 through 12. If you are asking for back rent, skip to questions 13 through 17. 8. Explain where you are staying now. Worker.

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