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Family Self-Sufficiency (FSS) Program Contract of Participation - HUD

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<strong>Family</strong> <strong>Self</strong>-<strong>Sufficiency</strong> <strong>Program</strong><br />

Individual Training and Services Plan<br />

Attachment ________<br />

Name <strong>of</strong> Participant<br />

Social Security Number<br />

Final Goal<br />

Interim Goal Number ________<br />

Date Accomplished __________________________<br />

Activities/Services Responsible Parties Date/s<br />

Comments<br />

Signatures:<br />

<strong>Family</strong><br />

____________________________________________________<br />

(Participant)<br />

___________________________________________________________________<br />

(Date Signed)<br />

Housing Agency<br />

____________________________________________________<br />

(Signature <strong>of</strong> HA Representative)<br />

___________________________________<br />

(Date Signed)<br />

Previous editions are obsolete<br />

Page 1 <strong>of</strong><br />

form <strong>HUD</strong>-52650 (12/2004)<br />

ref. Handbook 7420.8

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