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EXHIBIT B-9 9 9 10 6 8 5 8 <br /> VERIFICATION OF UNEMPLOYMENT BENEFITS <br /> RE: CLIENT: <br /> ADDRESS: <br /> CLAIM NO.: <br /> The above individual has indicated he/she is receiving benefits from your agency. Information provided will remain <br /> confidential and will be used solely for the purpose of determining eligibility for occupancy. <br /> BY <br /> TITLE <br /> I hereby authorize the above named management agent to make inquiries regarding my household income for the <br /> purpose of determining my eligibility for occupancy. <br /> Signed: <br /> Date: <br /> Weekly payments to client <br /> Beginning date of payments Ending date if known <br /> Is this client entitled to an extension of benefits? If yes,for how long? <br /> Remarks: <br /> By <br /> Title <br /> Date <br /> Phone <br /> PLEASE RETURN FORM TO: <br /> B-9-1 <br />