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LDSS-4623A (Rev. 9/2009) NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES ADOPTION SUBSIDY AND NON-RECURRING ADOPTION EXPENSES AGREEMENT Initial Application NOTE: Adoptive Parent(s) Please read
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How to fill out nys adoption subsidy tables

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How to fill out NYS adoption subsidy tables:

01
Gather all necessary information: You will need details regarding the child's name, date of birth, current living situation, and any relevant medical or special needs information. Additionally, information about the adoptive family, including income and expenses, will be needed.
02
Complete the initial section: Start by filling out the basic information about the child, such as their name, date of birth, and the date of the subsidy request. This section may also ask for information about the child's biological or legal parents.
03
Provide details about the child's current living situation: In this section, you will need to describe where the child is currently living. This includes information about the adoptive family, such as their relationship to the child and whether they are related by blood or marriage.
04
Enter information about medical or special needs: If the child has any medical conditions, disabilities, or special needs, you will need to provide detailed information about these in the appropriate section. This may include documentation from medical professionals or therapists.
05
Fill out the income and expenses section: This section asks for information about the adoptive family's income, including wages, benefits, and any additional sources. Provide accurate and detailed information about all sources of income. You will also need to provide information about the family's monthly expenses, including rent/mortgage, utilities, and food costs.
06
Review and submit the completed subsidy tables: Once you have filled out all the necessary sections, double-check the information for accuracy. Make sure all required fields are completed and that you have attached any required documentation. When you are confident in the accuracy of the information, submit the adoption subsidy tables as instructed by the relevant adoption agency or organization.

Who needs NYS adoption subsidy tables:

01
Prospective adoptive parents: If you are planning to adopt a child and believe you may be eligible for adoption subsidies in New York State, you will need to fill out the NYS adoption subsidy tables. These tables help determine the level of financial support you may be eligible for based on factors such as the child's needs and the family's income.
02
Adoptive families already receiving subsidies: If you are already receiving adoption subsidies in New York State, you may need to periodically update the information in the subsidy tables to ensure the continued eligibility and appropriate level of financial support for your adopted child.
03
Adoption agencies and organizations: Adoption agencies and organizations in New York State may also need to access and review the NYS adoption subsidy tables. They use this information to evaluate and determine the appropriate level of financial support for adoptive families, ensuring that children's needs are adequately met.
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NYS adoption subsidy tables are tables that provide information about the financial assistance available to adoptive parents in the state of New York.
Adoptive parents who receive financial assistance through the NYS adoption subsidy program are required to file the subsidy tables.
To fill out the NYS adoption subsidy tables, adoptive parents need to provide information about their income, the child's needs, and any other relevant financial information.
The purpose of the NYS adoption subsidy tables is to determine the amount of financial assistance that adoptive parents are eligible to receive based on their income and the needs of the adopted child.
Adoptive parents must report their income, the child's needs, and any other relevant financial information on the NYS adoption subsidy tables.
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