SFN 1059, Authorization for Release of Information 415-65-40
(Revised 12/1/03 ML #2895)
This form is available through the Department of Human Services and may also be obtained electronically via E-Forms.
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Low Income Home Energy Assistance Program (LIHEAP)
(Revised 12/1/03 ML #2895)
This form is available through the Department of Human Services and may also be obtained electronically via E-Forms.