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FS App/Reap/OP Recoup/Ad Only LDSS3152 (Rev. 1106) ACTION TAKEN ON YOUR FOOD STAMP BENEFITS CASE NAME AND ADDRESS OF AGENCY/CENTER OR DISTRICT OFFICE NOTICE DATE: CASE NUMBER IN NUMBER CASE NAME (And
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How to fill out ldss 3152:

01
Obtain a copy of ldss 3152 from the appropriate agency or online platform.
02
Fill in your personal information, including your name, address, and contact details.
03
Provide relevant information about your household, such as the number of people living with you and their relationship to you.
04
Complete the sections related to your income, including any wages, benefits, or other sources of income for each household member.
05
Fill out the section indicating any expenses or deductions you may have, such as childcare expenses or medical costs.
06
Sign and date the form to certify its accuracy and completeness.
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Submit the completed ldss 3152 to the designated agency or organization.

Who needs ldss 3152:

01
Individuals or families who are applying for or receiving government assistance programs may need to fill out ldss 3152.
02
This form is commonly required for programs such as Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and Medicaid.
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The purpose of ldss 3152 is to assess an individual or family's eligibility for assistance and determine the appropriate amount of benefits they may receive.
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LDSS 3152 is a form used by the New York State Office of Temporary and Disability Assistance to report changes in a household's circumstances for public assistance programs.
Individuals who are receiving public assistance benefits in New York State are required to file LDSS 3152 to report changes that may affect their eligibility or benefit amount.
To fill out LDSS 3152, start by providing your personal information, including name and case number. Next, report any changes such as income, household composition, housing status, or employment. Ensure all sections are completed accurately and sign the form.
The purpose of LDSS 3152 is to ensure that the New York State public assistance programs have up-to-date information about recipients' circumstances, which helps in determining eligibility and benefit amounts.
Information that must be reported on LDSS 3152 includes changes in income, changes in household members, changes in living arrangements, employment status, and any other circumstances that may affect eligibility for public assistance.
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