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Affordable Unit Address: <br />Head of Household (Print Name): <br />Current Address (if <br />different from above): <br />Telephone Number: Home: <br />Email address: <br />Date of Birth: <br />EXHIBIT E <br />INCOME VERIFICATION FORM <br />Work: <br />Social Security # or TIN: <br />List additional household members on a separate sheet of paper. <br />Exhibit E <br />55394.001 01\43724951.1 <br />Cell: <br />Page 64 <br />