NY DHS Form DHS-14 2018 free printable template

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DHS14 (E) 06/22/2018 (page 1 of 14)Client Name (First, Last):LOS 30 days: YesNoDOB:HFDS REFERRAL FORM Screening Tool for Referral from Health Care Facilities: SINGLE ADULT This HFDS Referral Form

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How to fill out NY DHS Form DHS-14

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Obtain the NY DHS Form DHS-14 from the official website or local office.

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Fill in your personal information, including your name, address, and contact details.

03

Provide information about your household members, including their names and relationships to you.

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Document your income sources and amounts accurately.

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List any assets you own, such as bank accounts or property.

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Complete any additional sections as required, based on your specific circumstances.

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Sign and date the form at the designated section.

Who needs NY DHS Form DHS-14?

01

Individuals or families applying for public assistance or welfare services in New York.

02

Applicants seeking benefits such as food stamps or temporary housing assistance.

03

Anyone who needs to report changes in their financial or household circumstances.

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What is NY DHS Form DHS-14?

NY DHS Form DHS-14 is a specific form used by the New York City Department of Homeless Services to gather information related to individuals applying for or receiving shelter services.

Who is required to file NY DHS Form DHS-14?

Individuals or families who are seeking shelter assistance from the New York City Department of Homeless Services are required to file NY DHS Form DHS-14.

How to fill out NY DHS Form DHS-14?

To fill out NY DHS Form DHS-14, applicants must provide accurate personal information, describe their housing situation, and provide details about their income and expenses. It's important to complete all required fields and sign the form.

What is the purpose of NY DHS Form DHS-14?

The purpose of NY DHS Form DHS-14 is to assess the eligibility of applicants for shelter services and to collect necessary information for processing their requests.

What information must be reported on NY DHS Form DHS-14?

The information that must be reported on NY DHS Form DHS-14 includes the applicant's personal details (name, address, contact information), household composition, income sources, expenditure details, and any other relevant information pertaining to their housing status.

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