New York State Office of Temporary and Disability Assistance Forms

This document is a form used in New York for requesting an authorized representative for the Supplemental Nutrition Assistance Program (Snap). It is available in Arabic language.

This Form is used for requesting to be an authorized representative for the Supplemental Nutrition Assistance Program (SNAP) in New York.

This Form is used for applying for the Supplemental Nutrition Assistance Program (SNAP) in New York. It is specifically meant for individuals who want to designate an authorized representative to handle their application.

This form is used for requesting a replacement of food purchased with SNAP benefits in New York. The form is available in English and Spanish.

This form is used to request authorization for a representative to handle Supplemental Nutrition Assistance Program (Snap) benefits in New York. It is available in Korean.

This form is used for determining the living arrangement of an individual in New York, specifically for Chinese-speaking residents.

This form is used for determining the living arrangement of individuals in New York. It is available in Arabic.

This form is used for determining the living arrangement of an individual in New York, specifically for individuals of Italian descent.

This form is used for reporting living arrangements in New York for individuals who speak Haitian Creole.

This Form is used for determining and reporting the living arrangement of an individual in the state of New York. It is available in Korean.

This form is used for reporting housing situations in New York. It is written in Spanish.

This form is used for documenting the living arrangement of individuals in New York who speak Russian.

This Form is used for enrolling in direct deposit for benefit payments in New York if you speak Russian.

This Form is used for enrolling in direct deposit for government benefits in New York. It is available in Chinese language.

This form is used for enrolling in the direct deposit program in the state of New York. The form is available in Haitian Creole language.

This document is used to cancel direct deposit for certain benefits in New York for individuals who speak Haitian Creole.

This form is used for canceling direct deposit in New York for Chinese residents.

This form is used for enrolling in direct deposit in the state of New York for individuals who speak Italian.

This form is used for enrolling in direct deposit in New York. (Spanish version)

This form is used for cancelling a direct deposit for benefits in New York. It is available in Korean language.

This form is used for canceling direct deposit in New York State for individuals who speak Russian.

This form is used for canceling direct deposit in New York for Korean-speaking individuals.

This form is used for canceling direct deposit in New York. The form is available in Arabic.

This form is used for cancelling direct deposit in New York. It is available in Arabic language.

This form is used for cancelling direct deposit in the New York state welfare system. It is specifically for Italian-speaking individuals.

This Formulario LDSS-5067 is used for cancelling direct deposit in New York.

This form is used for income verification in New York for Korean-speaking individuals. It is important for eligibility for various assistance programs.

This form is used for verifying income in New York for Chinese-speaking residents.

This Form is used for income verification in New York and it is in Spanish.

This Form is used for income verification in New York for Russian-speaking individuals.

This form is used for verifying income in New York for individuals who speak Haitian Creole.

This Form is used for designating a representative in the state of New York who can act on your behalf.

This document is for designating someone to represent you in New York if you speak Chinese.