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Primary Phone
Lifeline Program
Affordable Connectivity Program (ACP)
Eligibility Program
--select--
Federal public housing
Food stamps
Household income
Medical assistance (medicaid)
Supplemental security income (SSI)
Tribally-Administered Temporary Assistance for Needy Families (TTANF)
Tribal - Head start (Income qualifying Only)
Tribal - Food Distribution Program on Indian Reservations (FDPIR)
Tribal - Bureau of Indian Affairs General Assistance
Program Eligibility Approved by State Administrator
veteran’s pension
School Lunch/Breakfast Program*
Federal Pell Grant*
Substantial Loss of Income*
Existing low income program
Special Supplemental Nutrition Program for Women Infants, and Children (WIC)
Public Housing Program
--select--
Housing Choice Voucher Program
Project-based rental assistance
Public Housing
Affordable Housing Program for American Indians,Alaska Natives or Native Hawaiians
School Name
SSN (Last 4 Digits)
Has Alternate Id
Is Qualify Through Child or Dependent
Benifit Qualifying Person (BQP)
BQP Date Of Birth
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January (01)
February (02)
March (03)
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May (05)
June (06)
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29
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30
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31
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--Select Year--
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2022
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2021
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2020
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2019
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2018
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2017
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2016
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2015
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2014
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2013
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2012
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2011
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2010
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2009
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2008
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2007
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2006
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2005
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2004
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2003
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2002
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2001
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2000
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1999
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1998
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1997
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1996
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1995
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1994
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1993
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1992
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1991
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1990
;
1989
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1988
;
1987
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1986
;
1985
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1984
;
1983
;
1982
;
1981
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1980
;
1979
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1978
;
1977
;
1976
;
1975
;
1974
;
1973
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1972
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1971
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1970
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1969
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1968
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1967
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1966
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1965
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1964
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1963
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1962
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1961
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1960
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1959
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1958
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1957
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1956
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1955
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1954
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1953
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1952
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1951
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1950
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1948
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1945
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1944
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1943
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1942
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1941
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1940
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1939
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1938
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1937
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1936
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1935
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1934
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1933
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1932
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1931
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1930
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1929
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1928
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1927
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1926
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1925
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1924
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1923
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1922
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BQP SSN (Last 4 Digits)
Address
Street Address
Apartment or Suite
ZIP Code
City
State
--select state--
Alabama
Arkansas
California
Colorado
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
IIIinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
South Carolina
South Dakota
Texas
Utah
Vermont
Washington
West Virginia
Wisconsin
Wyoming
Mailing Address
Mailing Street Address
Mailing Apartment or Suite
Mailing ZIP Code
Mailing City
Mailing State
--select state--
Alabama
Arkansas
California
Colorado
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
IIIinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
South Carolina
South Dakota
Texas
Utah
Vermont
Washington
West Virginia
Wisconsin
Wyoming
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