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Get NY LDSS-3151 2002

LDSS-3151 Rev. 5/02 PAGE 1 NEW YORK STATE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE CASE NUMBER FOOD STAMP CHANGE REPORT FORM Please Print Clearly YOUR RESPONSIBILITY TO REPORT CHANGES YOU MUST REPORT ANY CHANGES IN YOUR CIRCUMSTANCES DATE ACCORDING TO THE RULES LISTED BELOW You may still voluntarily report any change about your household and if this change will increase your benefit level and you verify this change we will increase your bene.

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