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Reporting Form
1. Agency Report
Month and Year of Report:_________________
Staff Member Training CEUs
NewReferrals:____
Level 1 Claims? $____
Level 2 Claims? $____
HHF Claims?$____
Statuses
How many Incomplete? ____
Amerinational Incomplete?____
IHCDA Incomplete? ____
CounselorActionRequired?____
How many PendingServicerValidation? ____
How many Under IHCDA Review? ____
County # of Closings
Comments, questions,concerns?
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