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<br /> <br />PART 6: TOTAL INCOME RECEIVED BY FAMILY MEMBERS <br />APPLICANT (Head of Household): <br />Current Employment <br /> <br />Employer: _____________________________________________________________________________________ <br /> <br />Position Held: ______________________________________________ Years of Employment:____________________ <br /> <br />Employer Address: _____________________________________________________________________________________ <br /> <br />Phone: _____________________________________________ Gross Monthly Income: $_____________________ <br /> <br /> <br />CO-APPLICANT (Spouse or Co-Head): <br />Current Employment <br /> <br />Employer: _____________________________________________________________________________________ <br /> <br />Position Held: ______________________________________________ Years of Employment:____________________ <br /> <br />Employer Address: _____________________________________________________________________________________ <br /> <br />Phone: _____________________________________________ Gross Monthly Income: $_____________________ <br /> <br /> <br />If the current employment is for less than 2 years, complete the following: <br /> Previous Employment Years Employed Last Position Held Monthly Income <br /> <br />APPLICANT _____________________________ ____________ _____________ ___________ <br /> <br />CO-APPLICANT _____________________________ ____________ _____________ ___________ <br /> <br /> <br />OTHER GROSS MONTHLY INCOME <br />Please list gross payments (before taxes) made to each family member <br />security, SSI, disability, welfare assistance, unemployment benefits, retirement payments, child support, pension, <br />military pay, and business or professional income. <br />Gross Monthly Amount <br />Family Member Name Source of Income Address of Source <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />YES NO <br />\[ \] \[ \] Did you file a Federal Income Tax Return for the last full calendar year? <br /> <br />YES NO <br />\[ \] \[ \] Did you file a State Income Tax Return for the last full calendar year? <br /> <br />YES NO <br />\[ \] \[ \] Has anyone in your household applied for any benefit or money which is in the process of being <br />approved? If YES, please indicate what household member and for what benefit: <br /> ______________________________________________________________________________ <br /> ______________________________________________________________________________ <br /> <br />