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What is an Interim Report Form for State of Kansas 2004
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YOU NEED TO ATTACH PROOF OF THE MOST RECENT 30 DAYS OF EARNED INCOME THAT
HAS BEEN RECEIVED BY ALL HOUSEHOLD MEMBERS.
Use extra paper if needed to answer all the questions.
This action is based on Kansas Economic and Employment Support Manual Sections 9122 and
9372.
If you have questions, or need help completing the interim report form, contact your worker at
the SRS office.
1. List the full name and date of birth of all persons currently living in...
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