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* 1. What is your first and last name, on record with KCDC?

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* 2. What are the last 4 digits of your Social Security Number?

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* 3. What is your current mailing address?
This must be a valid address to receive mail from KCDC.

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* 4. What is your email address?

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* 5. Would you like to keep your housing application active with KCDC?

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