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TO: <br />RE: <br />Applit�ntiTanant Name <br />I hereby authorize release of my miliitary employment information. <br />Sipsture of Applicant/ Tenant <br />social securityNumim <br />Date <br />The individual named directly above is an applicanbtenant of a housing pcognm that requires verification of income. The information provided will remain <br />confidential and will be used solely for the puq=0 Of determining eligibility Ear occupancy, Your prompt vMxmsa is crucial and greatly appreciated. <br />Project Owmer/Managwmt Agent <br />Return Form To: <br />CW" FAmmga anticipated over next 12 months; <br />Monthly Base Pay <br />HAQ <br />FED -RATE <br />Clothing Allowance <br />Hazardous Duty Pay <br />Total Monthly Entitlemcat <br />Additional renntrk . <br />,lathorizcd Official Signature <br />Phooc # <br />Grade Level <br />Probability of Continued Enlistment <br />Comrtatted RaMans ._ <br />Other Special Pay <br />Total Annual atitlement <br />Authorized Official Printed Name & Title <br />Military Agency Address <br />Fax # <br />Date <br />E -rcail <br />N(yrF: yep [Jnn 1';;l l of T:tle 1X u: the L: S. Code maker it it criminal offense to make wiiltal ta,se statements or Ms'epresentations to any Dcvart"4nt or Ag`[ �y : It <br />i,nttad. ,;tales as to any :rattez w, his tta; arisdiction. ' <br />