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PART 6: TOTAL INCOME RECEIVED BY FAMILY MEMBERS <br /> APPLICANT (Head of Household): <br /> Current Employment <br /> Employer: <br /> Position Held. Years of Employment. <br /> Employer Address <br /> Phone Gross Monthly Income: 5 <br /> CO-APPLICANT(Spouse or Co-Head). <br /> Current Employment <br /> Employer: <br /> Position Held;, Years of Employment <br /> Employer Address: <br /> Phone- Gross Monthly Income 5 <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 /> APPLICANT <br /> CO-APPLICANT <br /> OTHER CROSS MONTHLY INCOME <br /> Please list gross payments(before taxes)made to each family member,for wages,worker's compensation,social <br /> security,SSI,disability,welfare assistance,unemployment benefits,retirement payments, child support, pension, <br /> military pay,and business orprofessional income. <br /> Family Member Name Source of Income Address of Source Gross Monthly Amount <br /> YES NO <br /> [ ] [ ] Did you file a Federal Income Tax Return for the last full calendar year? <br /> YES NO <br /> [ ] [ ] Did you file a State Income Tax Return for the last full calendar year? <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 />