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Get NY LDSS-3421 2010

Red Tank Is the heating bill in your name? Â… Yes Â… No If No, the bill is in the name of: ___________________________ Relationship to you: ________________________ Are you directly responsible to pay the bill? Â… Yes Â… No Â… Yes, provide a copy IF YOU DO NOT PAY FOR YOUR OWN HEAT, COMPLETE SECTION C BELOW: C. My household situation is: Â… Both Heat and Utilities are included in the rent Â… Heat is included in rent but I pay for utilities (lights/cooking/hot water). (Complete information bel.

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