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Handbook FORMS AND INSTRUCTIONS 63-1230 (Cont)

63-1230 STATE FORMS & INSTRUCTIONS (Continued) 63-1230

DFA 377.1 (12783) Manual Section(s)

Enter the applicable specific manual section(s) for the action(s), Distribution:

The original and one copy are provided to the household. The second copy is filed in the case record,

Rev. 1382 replaces . CALIFORNIA-DSS-MANUAL-SS Issue 2207 Effective 2/15/84

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