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NEW YORK STATE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE 40 NORTH PEARL STREET ALBANY, NY 12243-0001 George E. Atari Governor Robert Door Commissioner Informational Letter Section 1 Transmittal:
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05-inf-16 8-05 rev ldss-2642 is a form used for reporting information related to social services benefits.
Individuals receiving social services benefits are required to file 05-inf-16 8-05 rev ldss-2642.
05-inf-16 8-05 rev ldss-2642 can be filled out by providing accurate information about the social services benefits received.
The purpose of 05-inf-16 8-05 rev ldss-2642 is to ensure accurate reporting of social services benefits for monitoring and compliance purposes.
Information such as the type of social services benefits received, amount received, and duration of benefits must be reported on 05-inf-16 8-05 rev ldss-2642.
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