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Get and Sign Affidavit of Income 2008-2022 Form
Information is subject to verification by the State of California* I certify that the information presented in this letter is true and correct to the best of my knowledge and belief* Sincerely Signature of person receiving income This document must be hand written by the applicant. If the applicant cannot hand write they must put their mark X and include a printed name and signature of a witness. O. Box 138005 Sacramento CA 95813-8005 Dear Healthy Families and Medi-Cal for Families I am...
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