This is a legal form that was released by the New York State Office of Temporary and Disability Assistance - a government authority operating within New York.
The document is provided in Chinese. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is LDSS-4942?
A: LDSS-4942 is a form for the Supplemental Nutrition Assistance Program (SNAP) Authorized Representative Request in New York.
Q: What is the purpose of this form?
A: This form is used to appoint an authorized representative to handle SNAP benefits on behalf of an applicant or recipient.
Q: Who can use this form?
A: This form is for applicants or recipients of SNAP benefits in New York who wish to designate someone as their authorized representative.
Q: What is an authorized representative?
A: An authorized representative is a person designated by an applicant or recipient to act on their behalf in SNAP matters.
Q: What information is required on the form?
A: The form requires information about the applicant or recipient, as well as the authorized representative being appointed.
Q: Is this form available in languages other than Chinese?
A: Yes, this form is available in multiple languages, including English.
Q: How should I submit the completed form?
A: You should submit the completed form to the local LDSS office in person or by mail.
Q: Are there any fees associated with appointing an authorized representative?
A: No, there are no fees associated with appointing an authorized representative for SNAP.
Q: Can I change or revoke the appointment of an authorized representative?
A: Yes, you can change or revoke the appointment of an authorized representative at any time.
Q: Who should I contact if I have questions about this form?
A: You can contact your local LDSS office or the New York State Office of Temporary and Disability Assistance (OTDA) for assistance with this form.
Form Details:
Download a printable version of Form LDSS-4942 by clicking the link below or browse more documents and templates provided by the New York State Office of Temporary and Disability Assistance.