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Cost of Eyeglasses and Contact Lenses

Form number: 1069

This form is to be used for applications relating to the September 1, 2017–August 31, 2018 award year.

You must fill out this form if you wish to have the cost of visual aids for you or your child recognized as allowable expenses.

This expense can be allowed once per period of two consecutive award years for yourself, your child or your spouse’s child and may include the cost of an eyesight examination.

The prescription and proof of purchase must be submitted with the form.

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