
3 REV1 Exhibit 35: **Sample Citizenship Declaration ** INSTRUCTIONS: Complete this Declaration for each member of the household listed on the Family Summary Sheet LAST NAME FIRST NAME RELATIONSHIP TO HEAD OF HOUSEHOLD SEX DATE OF BIRTH - k
4350.3 rev-1 exhibit 3-5: **sample citizenship declaration ** instructions: complete this declaration for each member of the household listed on the family summary sheet last name first name relationship to head of household sex date of birth...
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