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Get and Sign MA DTA Permission to Share Information Form 2021-2022
Four Digits of SSN Date of Birth Section 2 Information to be Shared check one or both I allow DTA to share information about my TAFDC EAEDC and/or SNAP case with the SNAP Outreach Partner organization named in Section 3. I allow DTA and the SNAP Path to Work Provider named in Section 3 to share information about my TAFDC EAEDC and/or SNAP case to determine my eligibility for the SNAP Path to Work program and to share information about my participation and progress in the SNAP Path to Work...
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