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LDSS-5023 Rev. 2/15 NYS Office of Temporary Disability Assistance Congregate Care Change Report Form I. Return Instructions Please return this completed form to By E-mail By Fax Mailing Address otda*sm*ssp otda*ny. gov 518 486-3459 SSI State Supplement Program PO Box 1740 Albany New York 12201 II. Client Identification Name Social Security Number last four XXX-XXX- Date of Birth / New Residence Address New Provider Name and Address Former Provider Name and Address County Certificate/License/Provider III. Nature of Placement Transfer or Other Change Type of Placement Type of Care Federal/State Living Arrangement Move Into Moved Out of Federal Living Arrangement Code A State Code C Medical facility Community or Other please specify e*g* deceased Effective Date s of Change IV. Custody For children under 18 years old who has legal Parent/Guardian Social Services Other specify V. Income Changes Type of Income e*g* Social Security Retirement Social Security Disability Pension Wages Amount Da....

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The SSI Program is a federally funded program which provides income support to eligible individuals who are aged 65 or older, blind or disabled. SSI benefits are also available to qualified blind or disabled children. The SSP Program is the state program which augments SSI.

my Social Security account. On the My Home page scroll down to the Your Benefit Applications section and select View Details under the More Info heading. View your application status in the Current Status section. Check the status of your Social Security application online today!

You can request one online by using your personal my Social Security account, which will allow you to immediately view, print, and save a copy of the letter. You can call us to request one at 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday from 8:00 a.m. to 7:00 p.m. local time.

How to Get Proof of Your NYS SSP Benefits By calling the SSP Customer Support Center toll free at 1-855-488-0541. By emailing us at: otda.sm.ssp@otda.ny.gov. By faxing us at 518-486-3459. By writing us at: NYS OTDA. State Supplement Program. PO Box 1740. Albany, New York 12201.

An award letter (also known as an award notice) is what the Social Security Administration (SSA) sends out to inform an individual that a claim for benefits has been approved. Though award letters go out for any type of benefit application, the term is most commonly associated with disability claims.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232