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Get the free LDSS-4857 (Rev. 7/17) SUPPLEMENTAL NUTRITION - otda ny

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LDSS4857 (Rev. 7/17)AE/THE/IPA Closing/Closed Cases SNAPSUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) BENEFITS COMPROMISE/REPAYMENT AGREEMENT ACKNOWLEDGMENT NOTICE DATE:NAME AND ADDRESS OF AGENCY/CENTER
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LDSS-4857 rev 717 supplemental is a form used by the New York State Office of Temporary and Disability Assistance for reporting supplemental information related to benefits.
Individuals receiving benefits from the New York State Office of Temporary and Disability Assistance may be required to file LDSS-4857 rev 717 supplemental.
LDSS-4857 rev 717 supplemental can typically be filled out online or submitted through mail with the required information.
The purpose of LDSS-4857 rev 717 supplemental is to provide the Office of Temporary and Disability Assistance with additional information to determine eligibility for benefits.
Information such as income, household composition, and any changes in circumstances that may affect benefit eligibility must be reported on LDSS-4857 rev 717 supplemental.
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