Supplemental Nutrition Assistance Program (Snap) Application/recertification printable pdf download

LDSS-4826

(Rev. 8/12)

NEW YORK STATE OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE

SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM

(SNAP) APPLICATION/RECERTIFICATION

SNAP is the new name for the Food Stamp Program

Use this form if Applying For SNAP Only

If you are only applying for SNAP you can use this shorter application. If you would like to apply for other benefits such as Temporary Assistance,

Child Care Assistance, Home Energy Assistance or Medicaid please ask for a different application.

This application can only be used to apply for SNAP.

When You Are Applying For SNAP

You can file an application the same day you receive it. If you are eligible, benefits will be provided back to the filing date of your application.

You can file your application before you have an interview.

We must accept your application if, at a minimum, it contains your name, address (if you have one), and a signature. This information will establish your

application filing date. However, the application process, including the interview and a signature on page 5 of the application/recertification must be completed

for us to determine your eligibility.

You can apply for and get SNAP for eligible household member(s) even if you or some other members of your household are not eligible for benefits because

of immigration status. For example, ineligible alien parents can apply for SNAP for their children and receive benefits for their eligible children.

You can still apply and be eligible for SNAP even if you have reached your Temporary Assistance time limits.

Need SNAP Benefits Right Away?

You May Be Eligible For Expedited Processing of your SNAP Application.

If your household has little or no income or liquid resources, or if your rent and utility expenses are more than your income and liquid resources, or

you are a migrant or seasonal farmworker with little or no income or resources when you apply, you may be qualified to receive SNAP within 5

calendar days after the date that you apply. Your worker will always review your circumstances to see if you are qualified for expedited processing

of your SNAP application. A process is in place to issue SNAP benefits to all eligible households who meet the standards for expedited service.

Where You Can Apply For SNAP

If you live outside of New York City, you can apply on-line at myBenefits.ny.gov, or call or visit the social services district in the county where you

live and ask for an application package. You can get the address and phone number by calling toll free 1-800-342-3009.

If you live in New York City and you are not also applying for Temporary Assistance, you can apply on-line at myBenefits.ny.gov or call or visit any

SNAP Office and ask for an application package. You can get the address and phone number by calling 1-718-557-1399 or toll free

1-800-342-3009.

Having Problems Coming To Us For A SNAP Appointment?

If it is difficult for you to come in for a SNAP application appointment (reasons may include employment, health issues, transportation or child care

problems), you may have someone else apply for you, or you may apply on-line at myBenefits.ny.gov. You also can mail us your application or drop

it off and, in some circumstances; we can interview you by telephone.

Please contact your social services district if you have any questions, to see if you are eligible for a telephone interview, or if you need

to reschedule an interview.

Supplemental Nutrition Assistance Program (Snap) Application/recertification

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