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3.  Is your monthly household income lower than the income             guidelines outlined in the table below (be sure to include            ALL money received- work, child support, SSI, etc. - before             taxes have been taken out?

Family Size

Gross Monthly Income

2

$3,155

3

$3,898

4

$4,640

5

$5,383

6

$6,125

7

$6,264

8

$6,403

Yes No
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