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LDSS-4770 Rev. 8/12 TANF YOUTH SERVICES APPLICATION The information requested on this form is necessary to determine whether or not federal Temporary Assistance for Needy Families TANF funds may be used to provide services to you. This application form may be used by an applicant for services who is under 21 years of age. SECTION ONE A. Information About the Youth Applicant 1. Applicant s Name Home Address street apartment number city state zip code Social Security Number Date of Birth month...
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What is ldss 4770 form?
The LDSS 4770 form is a document that is used by individuals or families in need of assistance from the Department of Social Services (DSS) in New York State. It is an application form that must be filled out to apply for various programs and services offered by the DSS.
Who is required to file ldss 4770 form?
Anyone who wishes to apply for assistance programs and services offered by the Department of Social Services (DSS) in New York State is required to file the LDSS 4770 form. This includes individuals or families in need of financial assistance, healthcare coverage, food stamps, and other social welfare programs.
How to fill out ldss 4770 form?
To fill out the LDSS 4770 form, you need to provide required personal information such as name, address, date of birth, social security number, income details, family composition, and details of any assets owned. You also need to specify the assistance programs you are applying for and provide any supporting documentation required. The form can be obtained from the local Department of Social Services office or can be downloaded from their website.
What is the purpose of ldss 4770 form?
The purpose of the LDSS 4770 form is to gather necessary information from individuals or families seeking assistance from the Department of Social Services (DSS) in New York State. This information is used to determine eligibility for various programs and services offered by the DSS, such as financial assistance, healthcare coverage, and food stamps.
What information must be reported on ldss 4770 form?
The LDSS 4770 form requires you to report personal information including your name, address, date of birth, social security number, and contact information. You must also report details of your income, assets, expenses, and family composition. Additionally, you need to provide information about the assistance programs you are applying for and any supporting documentation required.
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