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Get NY LDSS-4882C 2012-2024

Insurance Benefits” questions below.  Public – Go to “Public Health Care Coverage” questions below.  Unknown – Go to “Section B – Supporting Documentation” on page A-7. Who provides the child’s private health care coverage? Health Care Coverage Information (Complete only if different for this child)  CP  Guardian  NCP/PF  Stepparent  Unknown  Other ________________________ Public Health Care Coverage W Name of Health Insurance Carrier Policy Number.

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