NY LDSS-3668 2015-2025 free printable template
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LDSS-3668 Rev. 11/15 SHELTER VERIFICATION Local District Name and Address Case Number Worker ID Case Name and Address Dear Sir/Madam We are currently reviewing the assistance case of the above named person. In order to complete our evaluation of this case we need information regarding household composition and shelter expenses. This form is for verification purposes only and does not imply any obligation on the part of this Agency. Please complete this questionnaire beginning with Section A...
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How to fill out ldss 3668 form
How to fill out NY LDSS-3668
01
Obtain a copy of the NY LDSS-3668 form from the New York State Office of Temporary and Disability Assistance website or your local social services office.
02
Read the instructions carefully to understand the requirements and details needed for completion.
03
Fill in your personal information, including your name, address, date of birth, and Social Security number.
04
Indicate the type of assistance you are applying for (e.g., public assistance, food stamps, etc.).
05
Provide information about your household members, including their names, ages, and relationship to you.
06
Disclose your income sources and amounts, as well as any expenses you incur each month.
07
Provide details regarding your living situation, such as whether you rent or own your home.
08
Sign and date the form to certify that the information is true and complete.
09
Submit the completed form to your local social services office by mail or in person.
Who needs NY LDSS-3668?
01
The NY LDSS-3668 form is needed by individuals and families in New York State who are applying for public assistance or related benefits.
02
It is typically required for those seeking support through social services programs like Temporary Assistance, SNAP (food stamps), or other welfare programs.
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What is NY LDSS-3668?
NY LDSS-3668 is a form used in New York State for reporting changes in circumstances for individuals receiving public assistance benefits.
Who is required to file NY LDSS-3668?
Individuals who are receiving public assistance benefits in New York State and experience changes in their personal or financial circumstances are required to file NY LDSS-3668.
How to fill out NY LDSS-3668?
To fill out NY LDSS-3668, individuals must provide accurate and complete information concerning their current situation, including but not limited to income, household composition, and any changes in employment or financial status.
What is the purpose of NY LDSS-3668?
The purpose of NY LDSS-3668 is to ensure that the information regarding an individual’s eligibility for public assistance is current and reflects any changes that may affect benefit amounts.
What information must be reported on NY LDSS-3668?
The information that must be reported on NY LDSS-3668 includes details about income, changes in employment, household members, expenses, and other factors that could impact eligibility for benefits.
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