Applicant’s Statement Of Farm/Self-Employed

123220 in stock

Restricted. For WIC Use Only.
SKU: WIC-32_1004 Categories: ,

Description

Form (REV 10/04) Restricted for WIC Use Only Use Section A when an applicant or any individual of the applicant’s household is self-employed. Use Section B when an applicant or any individual of the applicant’s household is a farmer.