General eligibility requirements that apply to all Apple Health programs

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Statement of Hmong or Highland Lao Tribal membership

Revised Date: 
July 25, 2014

Statement of Hmong or Highland Lao Tribal Membership

I declare, under penalty of perjury, that I was a Hmong or Highland Laotian tribe member when the tribe assisted the U.S. military during the Vietnam era (8/5/64 to 5/7/75).

Signature

Date