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Proof of Eligibility:
Guidelines and Examples
Online Portal Screenshot/Print out
Must have the name of the program, the customer’s name* and an issue date within the last 12 months
or a future expiration date.
*It is acceptable if it only has the first name or first name and middle initial. Verify that the last 4 digits
of the SSN and DOB match the application.
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Proprietary and Confidential 1/20/2020