Stimulus Checks Eligibility Form

Name

Validation: 3 to 40 alphabet characters (a-zA-Z)

Age

Validation: Number between 18 and 100 (18 < value < 100)

Profession

Validation: 6 to 20 alphabet characters (a-zA-Z)

Employment Status

Times on Welfare

NoneOnceTwice or More

Stimulus Check desired

Individual ($1000)Family ($2000)Business ($10000)

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