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Get Dpss Lacounty Gov Annual Redetermination

Al! Case Number (optional) Social Security Number (optional) Print Your Full Name (if you have not moved, put address label here if one is provided) Birth Date (optional) (mm/dd/yyyy) Current Street Address, Apartment Number (check here if address is new) Zip Code City/State Mailing Address (if different from above) City/State Zip Code Use ink and Print your answers. Make sure you sign and date the form. Use the postage paid envelope to return it. If you need more space, attach a.

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