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LESS 4827 (Rev. 5/16) INTENTIONAL PROGRAM VIOLATION DISQUALIFICATION NOTICE FOR THE PUBLIC ASSISTANCE PROGRAM NOTICE DATE: NAME AND ADDRESS OF AGENCY/CENTER OR DISTRICT OFFICE CASE NUMBER IN/RID NUMBER
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ldss- 4827 rev is a form used by the New York State Department of Social Services for reporting changes in income and expenses for individuals receiving benefits.
Individuals receiving benefits from the New York State Department of Social Services are required to file ldss- 4827 rev if there are any changes in their income or expenses.
ldss- 4827 rev can be filled out by providing accurate information about any changes in income and expenses, as well as any other requested details on the form.
The purpose of ldss- 4827 rev is to ensure that individuals receiving benefits have accurate and up-to-date information about their income and expenses, which may affect their eligibility for assistance.
Information such as changes in income, expenses, household composition, and any other relevant details must be reported on ldss- 4827 rev.
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