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4. Have you ever been e d -fro-ma dwelling for any reason7•'ES NO <br />If yes, please explain: <br />5. Does anyone live with you now who is not listed on page. 1 YES NO <br />If yes, please explain: <br />e. Does anyone plan to live with you in the future who is not listed on page 11 YES NO <br />If yes, please explain: <br />B. HOUSING REFERENCES (List ALL landlords during the past three years) <br />1. Present address <br />Name of present landlord <br />Address of landlord <br />Landlord's telephone no.. <br />Length of time at present address <br />Present monthly rent <br />Average monthly utility bills <br />If at present address less than three years, complete the following: <br />2. Previous address <br />Name of landlord <br />Address of landlord <br />Landlord's telephone no. <br />Length of time at this address <br />Monthly rent <br />Reason for moving <br />Average monthly utility bills <br />C. EMPLOYMENT OR OTHER INCOME SOURCES (List ALL sources) <br />Applicant's present employer(s) <br />Other adult's present employer(s) <br />r^rmn4,0,v§- 4% 111,a, %^r-a,iy O. r`nrnr%-%rna 1 1 n rnr 44;o%A n. ri-li,• Apww%o n+hr.lr 11 <br />