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This form is used for participating in the 457(B) Deferred Compensation Plan offered by Stanislaus County in California. It includes an agreement and service request.
This form is used for individuals who participate in self-directed services through the Jersey Assistance for Community Caregiving (JACC) program in New Jersey. It is an agreement that outlines the terms and conditions of the program.
This form is used for Somali refugees in Wisconsin who are applying for Refugee Cash Assistance (RCA). It is a participation agreement that outlines the terms and conditions of receiving RCA benefits.