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Get NY LDSS-4992 2014-2024

A HEAP benefit during the current HEAP program year OR You are currently receiving Temporary Assistance (TA) or Supplemental Nutrition Assistance Program (SNAP). If you DID receive a HEAP benefit during the current HEAP program year, your eligibility for a cooling benefit will be based on the information used to determine your HEAP benefit and the information submitted on this form. If you DID NOT receive a benefit during the current HEAP program year, BUT you are currently receiving TA or SNAP.

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