Form LDSS-5024 Designated Representative Form - New York (Russian)

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 Russian. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the LDSS-5024 Designated Representative Form?
A: The LDSS-5024 Designated Representative Form is a form used in New York to designate someone to represent you in matters related to public assistance and Medicaid.

Q: Who can use the LDSS-5024 Designated Representative Form?
A: Any individual in New York who is receiving or applying for public assistance or Medicaid can use the LDSS-5024 form to designate a representative.

Q: What is the purpose of the LDSS-5024 Designated Representative Form?
A: The purpose of the LDSS-5024 Designated Representative Form is to allow individuals to appoint someone to act on their behalf for matters related to public assistance and Medicaid.

Q: Do I need to fill out the LDSS-5024 Designated Representative Form in Russian?
A: If you are fluent in Russian and prefer to fill out the form in Russian, you can use the LDSS-5024 Designated Representative Form in Russian. Otherwise, you can use the English version of the form.