NY LDSS-5038 2018 free printable template
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Part Form 49a: Income Withholding Order (Spousal Support Only) LDSS5038 (8/18)Important Notice If you are issuing a Spousal Support Only Income Withholding Order, you must serve the completed LDSS5038
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How to fill out NY LDSS-5038
01
Obtain the NY LDSS-5038 form from the New York State Office of Temporary and Disability Assistance website or your local social services office.
02
Fill in your personal information at the top of the form, including your name, address, and contact information.
03
Indicate your household composition by listing all members living with you, including their names and relationships to you.
04
Provide details about your income, including all sources like employment, Social Security, and any other support.
05
Disclose any assets you may have, such as bank accounts, property, or vehicles.
06
Answer questions regarding your living situation, such as housing costs and any assistance you receive.
07
Review the form for completeness and accuracy before signing it.
08
Submit the completed form to your local social services office.
Who needs NY LDSS-5038?
01
Individuals or families applying for Temporary Assistance, Safety Net Assistance, or Medicaid in New York.
02
Those who are required to report changes in their financial situation or household composition to the local social services office.
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What is NY LDSS-5038?
NY LDSS-5038 is a form used in New York State for reporting changes in circumstances for individuals receiving public assistance or social services.
Who is required to file NY LDSS-5038?
Individuals who are recipients of public assistance or social services in New York State and experience changes in their circumstances are required to file the NY LDSS-5038.
How to fill out NY LDSS-5038?
To fill out NY LDSS-5038, you need to provide personal information including your name, address, and details about the changes in your circumstances. Follow the instructions provided on the form carefully.
What is the purpose of NY LDSS-5038?
The purpose of NY LDSS-5038 is to ensure that the New York State social services system has up-to-date information about recipients, which is necessary for the accurate calculation of benefits and services.
What information must be reported on NY LDSS-5038?
Information that must be reported on NY LDSS-5038 includes personal details, changes in income, household composition, employment status, and any other relevant changes that may impact eligibility for assistance.
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