Get the free YES - Office of Temporary and Disability Assistance - New York State - otda ny

LDSS-4887 (7/09) New York State Office of Temporary And Disability Assistance Of: Unit: Worker: Case Name: Case #: Dist Cd: MAIL-IN RECENT/ELIGIBILITY QUESTIONNAIRE To determine your continued eligibility

In our opinion, you have no need to submit documentation. If you have questions on the form or on your eligibility and should contact us by phone or fax at before completing a recertification form, to schedule a meeting, or to correct any errors, report them (by hand or by mail, to 516 E. 52nd St. and provide us with a postage paid return envelope) to your local Social Security office. You may return to our office with the recertification from any time after you submit it. The Office of Temporary and Disability Assistance provides the information presented below to serve the people that need our help. If you have questions, please call us at or fax us. If you are not familiar with your information, please call us at. Please visit our FAQs page for information on how we can help you. If you have a question about income verification for Temporary Assistance (TA) or Food Stamps (FS) please visit our FAQs page. When you fill out this form, it is important that you answer the questions truthfully and, if you know, list the information about the following information. Do you have a Social Security Number? If not, enter your Social Security number. If you have a valid Social Security Number, enter your Social Security Number. What is your employment status? Enter “M” if you have been a full-time employee, “F” if you have been employed part-time, “L” if you have been a temporary worker, “Q” if you are a seasonal worker, or “W” for workweek.

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