Statement About Food or Shelter Provided to Another

Claimant Statement About Loan of Food or Shelter; Statement about Food or Shelter Provided to Another

OMB: 0960-0529

IC ID: 46358

Documents and Forms

Document Name Document Type
Form SSA-L5063 Statement About Food or Shelter Provided to Another Form
SSA-L5063 Statement about Food or Shelter Provided to Another SSA-L5063 (revised).pdf Form
SSA-L5063 (current).pdf SSA-L5063 (current) IC Document