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Get CA MC 194 2007

Te Part I. Retain original for your records, copy for recipient/SSA. Client must take this form to SSA. • To Recipients: Read the back of this form. Take the necessary documentation to the Social Security Administration Office listed below in Part I.B. • To SSA: This form is a request for the action noted in Part I.C. Please complete Part II of this form and distribute as noted in Part I.A. If you have any questions, the eligibility worker’s name and phone number are provided. PART .

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