Legal Defender Application Full Financial

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checkbox_p2N
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or part time_1
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NO
YES
or part time
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NO_1
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I am currently receiving food stamps
I am currently receivingWelfare benefits TANF
I am currently receiving assistance fromMedicaid
I am currently receiving disability assistance
I am currently residing in public housing Section 8
NO
I am currently receiving unemployment benefits
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10/19/2026Click to Sign
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