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Race and Ethnicity
| American Indian / Alaska Native? |
|---|
Additional Information
| SSN |
|---|
Additional Information
| SSN | SSN Status | ||
|---|---|---|---|
| Citizen Status | Reason for not having SSN |
| Does the new household member have a Primary Caretaker (other than a parent), who is an existing household member? |
|---|
Citizenship Information
| Date of Entry |
| Immigration Status | |||
|---|---|---|---|---|---|
| Veteran Status |
