APPUClMON^jj^.y •, PLEASE READ THE 1 OLIOWING 3& tEFULLY BEIFORE COMP1 ETING THE FO
An application will not hp consider^.' iompl«it» a r.hpck f.i ?r»oney orto? lor $70,Ot> made payabh-to w » Ci'y 01 Cntaaijo s s; vww?k; on. payment of in* aiv;ii.->:r.it.».'. Plnase note: The application fee shall be waived 'or arf person holdinp nyai i m.-.v-nt ductal - cetevora pit*. Disability must Pr permanent es evHJerwerJ by a copy e i/'your valfci disflfc sel f po-wrd' and'or cornsof vtthtcft r
tine of app|ica»or<.
Proof of residency, in the form of a copy of your uriwr$ ilcenr.«, state identiJfic. [ion. r •utility hills are .ferfMicifrsd acjittw time of application.
Compjotrd application «©rm$ may be returned 10: the f,lta> :f your alderman, any. 5*ry c? Chicago-OeparinW:^ c£j*e>tjn;.K /acility. orvia nia'i at P.O. Bo* 803100. Chicago, ft. WV"U0-310H. ATTN:' Disab:sd-'F ASiS&WOwjoitepstaair-
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lO.OcflCrtptioaor Modic*i CondlhoD nnd Disability
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