[City of Tamarac] Food Pantry Application 2024

Tamarac Food Pantry Registration Form

APPLICANT

First Name

Last Name

Phone Number

HOUSEHOLD INCOME

Total Family Size

Children (0-17 years of age):

Adults (18+ years of age):

Select Income

Do you receive SNAP benefits (Food Stamps)

Yes

If yes, what is your monthly benefit amount?

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First Name

Last Name

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Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

REQUIRED DOCUMENTS

Applicant ID & Proof of Residency

Proof of Household Income

Food stamp Statement (if applicable)

Applicant ID and Proof of Residency

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Proof of Household Income

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Food Stamp Statement

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For Office Use ONLY

Household Income is: