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Get NY LDSS-5030 2015-2024

(Street or PO Box) (City) (State) (Zip Code) Mailing Address if different than residence address (Street or PO Box) (City) (State) (Zip Code) Please tell us the date that your current living arrangement began: (Month/Year) Using the definitions below, please check the box that best reflects your current living arrangement. Living Alone You fit in this cate.

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