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LDSS3421(Rev. 5/20)HOME ENERGY ASSISTANCE PROGRAM APPLICATION If you are blind or seriously visually impaired and need this application in an alternative format, you may request one from your social
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The 2017-2020 form NY LDSS-3421 is needed by individuals or households who are applying for certain welfare benefits or services in the state of New York.
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Form NY LDSS-3421 is an application for Public Assistance and/or Supplemental Nutrition Assistance Program (SNAP) benefits in New York.
Individuals seeking to apply for Public Assistance or SNAP benefits in New York are required to file form NY LDSS-3421.
To fill out form NY LDSS-3421, you must provide personal information, household details, income sources, expenses, and any special circumstances that may apply to your situation.
The purpose of form NY LDSS-3421 is to assess eligibility and determine the amount of Public Assistance and/or SNAP benefits that an individual or household may qualify for.
Information that must be reported includes personal identification details, income, expenses, household composition, and other relevant financial information.
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