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  • Please answer all of the following questions. By way of this form, you attest that the information provided is true and accurate. The purpose of this form is to collect information to verify your household income to satisfy the requirements of Section 196.1978, Florida Statutes. Please note that every occupant is required to submit this form.
  • Please note that every occupant in your unit must complete this form.

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  • I certify that the information provided, including all submitted documents, is accurate and correct.
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