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LDSS4015 A NYC (Rev. 11/06)NOTICE OF INTENT TO CHANGE BENEFITS:PART APA, MA, FS, Serve ChangePUBLIC ASSISTANCE, FOOD STAMP BENEFITS, MEDICAL ASSISTANCE COVERAGE AND SERVICES (TIMELY & ADEQUATE) (NYC)
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LDSS-4015 A NYC REV is a form used by individuals to report their income and resources to the New York City Human Resources Administration (HRA) for the purpose of determining eligibility for public assistance programs.
Individuals who are applying for or receiving public assistance benefits in New York City are required to file LDSS-4015 A NYC REV.
LDSS-4015 A NYC REV can be filled out online through the HRA ACCESS NYC website or by completing a paper form and submitting it to the HRA office.
The purpose of LDSS-4015 A NYC REV is to collect information about an individual's income and resources in order to determine their eligibility for public assistance programs.
On LDSS-4015 A NYC REV, individuals must report their income, assets, household members, expenses, and other relevant information.
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