EDITS - Enrollment Announcement and Form Submission
 
 
Friday, April 25, 2014
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       01/2014:
    Revised the Application Budget Explanation log file layout to include Contribution From Spouse and Contribution To Spouse fields.
  • Code RJ-Case Reason Description: Other. Please explain why cases receive this reason and how to correct these cases for resubmission. Thank you.
  • On 6/15/12 ( last day reconsiderations) our previous Medicaid Coordinator submitted a reconsideration for Maud Butcher a resident of ours. How do I go about obtaining the information he submitted via the Marc system? Your assistance would be greatly appreciated
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    Doc Category Cat Description Doc Type Document Description
    01 Personal Documents 6995 "K" VISA
    01 Personal Documents 6997 "S" VISA
    01 Personal Documents 6999 "U" VISA
    01 Personal Documents 7000 "V" VISA
    01 Personal Documents 0236 Adoption Papers
    01 Personal Documents 1838 Affidavit sworn u/penalty o/law s/he Hmong/Laotion betw 8/5/64&5/7/75
    01 Personal Documents 7859 Afghan passport admitted under 101(a)(27) of the INA
    01 Personal Documents 7862 Afghan Passport stamped admitted under SI-1, SI-2, SI-3
    01 Personal Documents 7863 Afghan Passport stamped admitted under SQ-1, SQ-2, SQ-3
    01 Personal Documents 7867 Afghan Passport stamped SQ-6, SQ-7, SQ-9, SI-6, SI-7, SI-9
    01 Personal Documents 7860 Afghan Passport with stamp showing admitted under101(a)(27of the INA
    01 Personal Documents 1044 AFIS Photo
    01 Personal Documents 7704 Any authoritative document from the USCIS indicating deferred action
    01 Personal Documents 7497 Any other USCIS document ind alien has a K or V visa
    01 Personal Documents 6986 Any verification from US Immigration or other authoritative documents
    01 Personal Documents 6906 Armed Forces Serial Number
    01 Personal Documents 0044 Baptismal Certificate
    01 Personal Documents 6802 Baptismal Certificate with place and date of birth in USA/Territories
    01 Personal Documents 7779 Begin 3-month ISP Progress Report Language Workstudy or Workstudy
    01 Personal Documents 7780 Begin 6-month ISP Progress Report Language Workstudy or Workstudy
    01 Personal Documents 7781 Begin 9-month ISP Progress Report Language Workstudy or Workstudy
    01 Personal Documents 7538 Begin Absence Documentation
    01 Personal Documents 7782 Begin Final ISP Progress Report Language Workstudy or Workstudy
    01 Personal Documents 7786 Begin Participant Worksite Evaluation 3-month Language Workstudy-Work
    01 Personal Documents 7787 Begin Participant Worksite Evaluation 6-month Language Workstudy-Work
    01 Personal Documents 7788 Begin Participant Worksite Evaluation 9-month Language Workstudy-Work
    01 Personal Documents 7783 Begin POP Assessment Form Employment Plus
    01 Personal Documents 7785 Begin Work Skills Interest Form Internship
    01 Personal Documents 7784 Begin Work Skills Interest Form Language Workstudy or Workstudy
    01 Personal Documents 8461 BFI-Copy of Warrant
    01 Personal Documents 8462 BFI-Rap Sheet and Photo
    01 Personal Documents 0008 Birth Certificate Bureau of Vital Statistics
    01 Personal Documents 8196 Birth Certificate from Puerto Rico Issued on or After 7/1/2010
    01 Personal Documents 7122 Birth or baptismal cert issued on a reservation
    01 Personal Documents 0004 Birth/Hospital Certificate
    01 Personal Documents 6801 Birth/Hospital Certificate with place of birth within USA/Territories
    01 Personal Documents 8335 CAS-102 Activities of Daily Living
    01 Personal Documents 8336 CAS-103 Physician?s Assessment Form
    01 Personal Documents 1690 CBIC-Common Benefit Identification Card
    01 Personal Documents 6903 Census Records
    01 Personal Documents 1076 Certificate from Commission for the Blind
    01 Personal Documents 1766 Certificate of Domestic Partnership
    01 Personal Documents 7807 CHAT- CAS Determination Letter
    01 Personal Documents 7809 CHAT- Confidentiality Agreements
    01 Personal Documents 7804 CHAT- Homelessness Hx Documentation
    01 Personal Documents 7808 CHAT- NESHA Applications
    01 Personal Documents 7805 CHAT- Substance Abuse Tx Documentation
    01 Personal Documents 7806 CHAT- TB Documentation
    01 Personal Documents 7803 CHAT- W-900W Psychiatric Evaluation
    01 Personal Documents 7802 CHAT- W-900X Psychosocial Assessment
    01 Personal Documents 0932 Court or Agency Placement Papers
    01 Personal Documents 6994 Court order granting suspension of deportation pursuant to sec 244
    01 Personal Documents 0228 Court Records clearly establishing relationship
    01 Personal Documents 6899 Criminal Court Records
    01 Personal Documents 7964 CS-925 Application For Child Care Subsidy
    01 Personal Documents 7443 Current Letter from Registrar's or Bursar's office
    01 Personal Documents 7530 Current Military Orders
    01 Personal Documents 0055 DD-214 Certificate of Release or Discharge from Active Duty
    01 Personal Documents 0084 DD-214 Discharge Certificate that states Honorable
    01 Personal Documents 0240 Death Certificate relationship
    01 Personal Documents 1080 Disability Certificate from NYS or NYC Disability Review Team
    01 Personal Documents 5766 Discharge to Foster Care Placement with Special Services for Children
    01 Personal Documents 0080 Divorce Separation Annulment Papers
    01 Personal Documents 0196 Doctor Clinic Pregnancy Statement with EDC Date
    01 Personal Documents 8460 Document from religious org stating SSN is in conflict with doctrine
    01 Personal Documents 1832 Document verifying that individual was receiving MA on 8/24/97
    01 Personal Documents 7375 Documentation certifying need for Other Special Grant request
    01 Personal Documents 7701 Documents from the USCIS indicating an Order of Supervision
    01 Personal Documents 7171 Documents verifying need for emgency child care payment reimbursement
    01 Personal Documents 0036 Driver's License
    01 Personal Documents 7572 DS-1350 Certification of Report of Birth
    01 Personal Documents 8198 DSP-Consultative Examination Results
    01 Personal Documents 5502 DSS-3367 Refugee and Cuban Haitian Entrant Reporting
    01 Personal Documents 5438 DSS-4060 Declaration of Citizenship Immigration Status
    01 Personal Documents 8000 Employment Authorization Document
    01 Personal Documents 0024 EPFT-Photo ID with Signature
    01 Personal Documents 1872 Evidence of battery and abuse
    01 Personal Documents 6513 EXP-191N Certification of Citizenship or Alien Status
    01 Personal Documents 8318 FIA-1028a Notification of Home Visit Needed/Homebound Status Determine
    01 Personal Documents 8319 FIA-1028b Home Visit Appointment Notice
    01 Personal Documents 8320 FIA-1028c Mandatory Appointment Notice for NCA Food Stamp Application
    01 Personal Documents 8323 FIA-1028f Refusal of Cash Assistance App/Recert/Home Visit Appointment
    01 Personal Documents 8349 FIA-1046 Home Visit Needed/Homebound Status Extended for Ninety Days
    01 Personal Documents 8294 Field Visit Report HASA
    01 Personal Documents 0040 Foreign Passport
    01 Personal Documents 6979 Form I-220B (Order of Supervision)
    01 Personal Documents 7571 FS-240 Consular Report of Birth
    01 Personal Documents 1824 Grant letter from Asylum Office of US Immigration
    01 Personal Documents 8020 Guardian Ad Litem
    01 Personal Documents 7905 HA 4631 Claimant's Medical Treatment
    01 Personal Documents 7906 HA 4632 Claimant's Medications
    01 Personal Documents 7907 HA 4633 Claimant's Work Background
    01 Personal Documents 8008 HASA Court Documentation
    01 Personal Documents 8626 HASA Financial Management Package
    01 Personal Documents 8009 HASA Medical Documentation
    01 Personal Documents 1853 HASA Only-Attorney letter verifying appl deferred Immigration action
    01 Personal Documents 0188 Health Ins Plan ID-Statement
    01 Personal Documents 6907 Health Insurance Card with Social Security Number
    01 Personal Documents 0056 High School College Degree
    01 Personal Documents 1702 High School Diploma GED Certificate
    01 Personal Documents 8292 Home Care Package HASA
    01 Personal Documents 8316 Home Visit Needed/Homebound Status Documentation
    01 Personal Documents 8291 Homemaking Package HASA
    01 Personal Documents 0016 Hospital Letter for newborns
    01 Personal Documents 0176 Hospital Release Papers
    01 Personal Documents 6828 I-181 Memo of Creation of Lawful Permanent Residence w approval stamp
    01 Personal Documents 6990 I-210 Voluntary Departure
    01 Personal Documents 0148 I-210 Voluntary Departure
    01 Personal Documents 0152 I-220B Order of Supervision
    01 Personal Documents 0116 I-279 I-97 Resident Citizen ID
    01 Personal Documents 0132 I-327 Re-entry Permit of Permanent Residents
    01 Personal Documents 7079 I-485 Application to Register Permanent Resident or Adjust Status
    01 Personal Documents 7858 I-539 Application to Extend/Change Non-immigrant Status
    01 Personal Documents 0124 I-551 Alien Registration Card
    01 Personal Documents 1798 I-551 Alien Registration Card stamped "AM1,AM2,AM3,AM6,AM7,AM8"
    01 Personal Documents 8637 I-551 Alien Registration Card stamped "ST0"
    01 Personal Documents 8638 I-551 Alien Registration Card stamped "ST6"
    01 Personal Documents 8639 I-551 Alien Registration Card stamped "ST7"
    01 Personal Documents 8640 I-551 Alien Registration Card stamped "ST8"
    01 Personal Documents 8641 I-551 Alien Registration Card stamped "ST9"
    01 Personal Documents 7866 I-551 Alien Registration stamped SQ-6, SQ-7, SQ-9, SI-6, SI-7, SI-9
    01 Personal Documents 1804 I-551 stamped in foreign passport or on I-94 Unexpired temporary
    01 Personal Documents 1796 I-551Alien Registration Card stamped "CU6, CU7 or CH6"
    01 Personal Documents 1818 I-571 Refugee Travel Document
    01 Personal Documents 6983 I-688 Employment Authorization Card coded 274a.12(a)(11) or A11
    01 Personal Documents 6991 I-688 Employment Authorization Card coded 274a.12(c)(10) or C10
    01 Personal Documents 6988 I-688 Employment Authorization Card coded 274a.12(c)(14) or C14
    01 Personal Documents 6800 I-688 Employment Authorization Card coded 274a.12(c)(18) or C18
    01 Personal Documents 0136 I-688 Temporary Residence Card
    01 Personal Documents 7738 I-688A coded 245A
    01 Personal Documents 7715 I-688B (EAD) cat. 8 CFR 274a12(a)(15) or A15
    01 Personal Documents 7705 I-688B (EAD) cat. 8 CFR 274a12(a)(9) or A9
    01 Personal Documents 7717 I-688B (EAD) cat. 8 CFR 274a12(c)(16) or C16
    01 Personal Documents 7708 I-688B (EAD) cat. 8 CFR 274a12(c)(21) or C21
    01 Personal Documents 8683 I-688B (EAD) category 8 CFR 274a.12 (a)(14) or A(14)
    01 Personal Documents 7731 I-688B (EAD) coded 27a12(c)(19) or C19
    01 Personal Documents 7729 I-688B (EAD) coded 8 CFR 274a12(a)(12) or A12
    01 Personal Documents 7723 I-688B (EAD) coded 8 CFR 274a12(a)(8) or A8
    01 Personal Documents 7726 I-688B (EAD) coded 8 CFR 274a12(c)(8) or C8
    01 Personal Documents 7733 I-688B (EAD) coded 8 CFR 274a12(c)(9) or C9
    01 Personal Documents 7739 I-688B coded 8 CFR 274a12(c)(22) or C22
    01 Personal Documents 1060 I-688B Employment Authorization Card
    01 Personal Documents 8350 I-688B Employment Authorization Card coded 274a.12(a)(19) or A19
    01 Personal Documents 8351 I-688B Employment Authorization Card coded 274a.12(a)(20) or A20
    01 Personal Documents 7716 I-766 (EAD) cat. 8 CFR 274a12(a)(15) or A15
    01 Personal Documents 7718 I-766 (EAD) cat. 8 CFR 274a12(c)(16) or C16
    01 Personal Documents 7709 I-766 (EAD) cat. 8 CFR 274a12(c)(21) or C21
    01 Personal Documents 7706 I-766 (EAD) cat. CFR 274a12(a)(9) or A9
    01 Personal Documents 8684 I-766 (EAD) category 8 CFR 274a.12 (a)(14) or A(14)
    01 Personal Documents 7732 I-766 (EAD) coded 27a12(c)(19) or C19
    01 Personal Documents 7730 I-766 (EAD) coded 8 CFR 274a12(a)(12) or A12
    01 Personal Documents 7724 I-766 (EAD) coded 8 CFR 274a12(a)(8) or A8
    01 Personal Documents 7727 I-766 (EAD) coded 8 CFR 274a12(c)(8) or C8
    01 Personal Documents 7734 I-766 (EAD) coded 8 CFR 274a12(c)(9) or C9
    01 Personal Documents 7529 I-766 annotated C11 or A4 & I-94 indicating admitted at least one year
    01 Personal Documents 8689 I-766 cat code A19, A20 & exp date<4 yrs fr date of application
    01 Personal Documents 7740 I-766 coded 8 CFR 274a12(c)(22) or C22
    01 Personal Documents 6984 I-766 Employment Authorization Card coded 274a.12(a)(11) or A11
    01 Personal Documents 8352 I-766 Employment Authorization Card coded 274a.12(a)(19) or A19
    01 Personal Documents 8353 I-766 Employment Authorization Card coded 274a.12(a)(20) or A20
    01 Personal Documents 6992 I-766 Employment Authorization Card coded 274a.12(c)(10) or C10
    01 Personal Documents 6989 I-766 Employment Authorization Card coded 274a.12(c)(14) or C14
    01 Personal Documents 6978 I-766 Employment Authorization Card coded 274a.12(c)(18) or C18
    01 Personal Documents 1814 I-766 Employment Authorization Document annotated "A5"
    01 Personal Documents 8635 I-766 Employment Authorization Document annotated (a)(16)
    01 Personal Documents 8636 I-766 Employment Authorization Document annotated ?(25)
    01 Personal Documents 7725 I-797 Asylum Application received, pending or approve asylum request
    01 Personal Documents 7707 I-797 document indicating application for I-130 is pending/approved
    01 Personal Documents 7711 I-797 Early "U" VISA Application Notice of Deferred Action
    01 Personal Documents 7735 I-797 indicating application received, pending or approved
    01 Personal Documents 7499 I-797 indicating approved I-130 visa petition
    01 Personal Documents 1875 I-797 indicating receipt (pending) I-360 self-petition under VAWA
    01 Personal Documents 7728 I-797 indicating TPS status granted
    01 Personal Documents 6987 I-797 Notice of Action/other form show appr of deferred action status
    01 Personal Documents 7719 I-797 Notice of Status to Permanent Resident pursuant - INA Sec 249
    01 Personal Documents 1772 I-94 - Section 212(d)(5) of the INA"
    01 Personal Documents 1778 I-94 - stamped "CU6 or CU7"
    01 Personal Documents 7002 I-94 and I-210 indicating departure on a specific date
    01 Personal Documents 7700 I-94 annotated "Order of Supervision"
    01 Personal Documents 7736 I-94 or stamp in passport annotated "adjustment application"
    01 Personal Documents 7737 I-94 or stamp in passport annotated, "employment authorized"
    01 Personal Documents 1780 I-94 stamped " AM1, AM2, AM3, AM6, AM7, AM8 "
    01 Personal Documents 7722 I-94 stamped "DS" (Duration of Status)
    01 Personal Documents 6980 I-94 stamped "Granted an indefinite stay of deportation"
    01 Personal Documents 6985 I-94 stamped "Granted indefinite volunt departure status under sec 244
    01 Personal Documents 6993 I-94 stamped "Granted suspension of deportation pursuant to sec 244"
    01 Personal Documents 7712 I-94 stamped "U1", "U2", "U3" or "U4"
    01 Personal Documents 7714 I-94 stamped "V1", "V2", "V3"
    01 Personal Documents 0128 I-94-Stamp in Passport
    01 Personal Documents 6914 Insurance or Health policy card
    01 Personal Documents 7886 Iraqi passport admitted under 101(a)(27) of the INA
    01 Personal Documents 7864 Iraqi Passport stamped admitted under SI-1, SI-2, SI-3
    01 Personal Documents 7865 Iraqi Passport stamped admitted under SQ-1, SQ-2, SQ-3
    01 Personal Documents 7868 Iraqi Passport stamped SQ-6, SQ-7, SQ-9, SI-6, SI-7, SI-9
    01 Personal Documents 7861 Iraqi Passport with stamp showing admitted under101(a)(27 of the INA
    01 Personal Documents 7667 IREA L&R Personal Injury Liens
    01 Personal Documents 8290 Legal Documentation HASA
    01 Personal Documents 7004 Letter acknowldg alien's presence in US w/stmt that deportation is not enforced
    01 Personal Documents 0092 Letter from Community Institution ID
    01 Personal Documents 0164 Letter from Hospital Social Worker
    01 Personal Documents 8044 Letter From Primary Tenant Verifying Residence
    01 Personal Documents 0940 Letter from U.S. Justice Department
    01 Personal Documents 1836 Letter or Tribal document certifying at least 50 Amer.Indian Blood
    01 Personal Documents 8309 M-322h Pregnancy Benefits and Your Responsibility to Report Childbirth
    01 Personal Documents 8034 M-327m Mailer Notice to Return Documents/Report to the Job Center
    01 Personal Documents 7146 M-76k Consent for a Substance Abuse Assessment of a Minor
    01 Personal Documents 7692 M-76M Consent for Release of HIV and Related Information
    01 Personal Documents 7691 M-76N Alcohol & SA Treatment Records
    01 Personal Documents 6266 MAP /E E1406 Change of Address Questionnaire
    01 Personal Documents 1032 MAP-480W Birth of Cash Assist-Participant/Managed Care Enroll W-538D
    01 Personal Documents 7935 MAP-635P Referral For A Face To Face Interview
    01 Personal Documents 0012 Marriage Certificate with DOB
    01 Personal Documents 0048 Marriage Certificate without DOB
    01 Personal Documents 0064 Medicaid Card
    01 Personal Documents 6069 Medical Examination of Aliens Seeking Adjustment of Status
    01 Personal Documents 0920 Medicare Acceptance Letter or Statement
    01 Personal Documents 0068 Medicare Card
    01 Personal Documents 7198 Medicare Drug Discount Card
    01 Personal Documents 1878 Membership card or Tribal doc. for federally recognized tribe-Sec4(e)
    01 Personal Documents 0028 Military ID DD Form 2 Active with expiration date more than 1 year
    01 Personal Documents 0180 Military Retirement Disability Papers
    01 Personal Documents 0108 N550,N570 Certificate of Naturalization
    01 Personal Documents 0104 N560 Certificate of Citizenship
    01 Personal Documents 7586 Non-Citizen Referral to SSA for Social Security Number FA and or FS
    01 Personal Documents 0900 Non-Driver's License
    01 Personal Documents 6981 Notice/letter showing cont exclusion/deportation proceeding
    01 Personal Documents 6267 NYS Finger Imaging System-Records Management Fingerprint and Photo ID
    01 Personal Documents 8749 OCSE-191 Notice to Respondent
    01 Personal Documents 7702 Order fr EOIR granting cancellation of removal
    01 Personal Documents 1826 Order from immigration judge granting asylum
    01 Personal Documents 6807 ORR Certification Letter
    01 Personal Documents 6808 ORR Letter for Children
    01 Personal Documents 0100 Other Acceptable ID
    01 Personal Documents 0160 Other Citizenship
    01 Personal Documents 1052 Other Proof of Child's Temporary Absence
    01 Personal Documents 0204 Other Proof of Non-Residence-NYS
    01 Personal Documents 7126 Other Public records that can show residence in the U.S. From 1972
    01 Personal Documents 7713 Other USCIS authoritative document that verifies "U" visa status
    01 Personal Documents 1860 Passport - with stamp showing alien status and date status granted
    01 Personal Documents 0060 Photo ID any source
    01 Personal Documents 0232 Physician's Statement of Birth & Parentage relationship
    01 Personal Documents 5002 Power of Attorney
    01 Personal Documents 0072 Prison Arrest Parole Records
    01 Personal Documents 0168 Prison Release Papers
    01 Personal Documents 6326 Receipt for I-90 Submitted Without Fee
    01 Personal Documents 8195 Refugee Training Program
    01 Personal Documents 0120 Reporting Birth of US Citizen Abroad FS240,FS545,DS1350
    01 Personal Documents 7442 School letter with expected date of graduation
    01 Personal Documents 0020 Selective Service Registration Certificate
    01 Personal Documents 0244 Social Security Card
    01 Personal Documents 1258 SS5 Application for Social Security Number
    01 Personal Documents 8459 SSA letter confirming error was made-Not Deceased
    01 Personal Documents 0252 SSA Printout verification only
    01 Personal Documents 0248 SSA-2853 Social Security Receipt
    01 Personal Documents 5908 SSA-2872 Statement of Death and Burial Services by Funeral Director
    01 Personal Documents 8625 SSA-4164 Advance Notification of Representative Payment
    01 Personal Documents 5726 SSA-5028 Receipt for Application for a Social Security Card
    01 Personal Documents 8624 SSA-787 Physician?s/Medical Officer?s Statement
    01 Personal Documents 6254 SSA-795 Statement of Claimant or Other Person
    01 Personal Documents 7585 SSA-L676 SSN Card Denial Notice
    01 Personal Documents 7425 Statement from Another Person Re Age
    01 Personal Documents 6900 Statement from Another Person Re Identity
    01 Personal Documents 6902 Statement From Clergy
    01 Personal Documents 0096 Statement from Friend Neighbor Relative ID
    01 Personal Documents 7418 Statement from Home or health attendant organization program
    01 Personal Documents 0192 Statement from Medical Professional Medical Institution/Facility
    01 Personal Documents 7308 Statement from Medical Professional verifying pregnancy EDC
    01 Personal Documents 0172 Statement from Probation-Parole Officer
    01 Personal Documents 7306 Statement from Provider of Health Insurance Premiums
    01 Personal Documents 0106 Statement from Rehab V E S I D
    01 Personal Documents 0114 Statement from School Authorities
    01 Personal Documents 0110 Statement from Social Worker
    01 Personal Documents 0118 Statement from Training Institution
    01 Personal Documents 5003 Summons
    01 Personal Documents 5004 Sworn Statement
    01 Personal Documents 8745 TCC316.1 Approval document from Dept of Labor
    01 Personal Documents 7373 Three Estimates from clothing or uniform retailer
    01 Personal Documents 8685 Unexpired I-688B (EAD) cat 8 CFR 274a.12(a)(19) or A19
    01 Personal Documents 8687 Unexpired I-688B (EAD) cat 8 CFR 274a.12(a)(20) or A20
    01 Personal Documents 8686 Unexpired I-766 (EAD) cat 8 CFR 274a.12(a)(19) or A19
    01 Personal Documents 8688 Unexpired I-766 (EAD) cat 8 CFR 274a.12(a)(20) or A20
    01 Personal Documents 0948 US Armed Forces Active Duty Statement
    01 Personal Documents 0156 US Immigration Letter Indicating Individual Applied for Asylum
    01 Personal Documents 0112 US Passport
    01 Personal Documents 7129 US Residence prior to 8/22/96 verified by rent/mortgage records
    01 Personal Documents 8093 USA Passport Card
    01 Personal Documents 7710 USCIS authoritative document that verifies "S" visa status
    01 Personal Documents 7703 USCIS document withholding of deportation or cancellation of removal
    01 Personal Documents A230 USCIS Documentation Not Listed Above
    01 Personal Documents 7720 USCIS or EOIR indicating Registry Application (I-485) is pending
    01 Personal Documents 1822 Vietnamese exit visa or passport stamped "AM1, AM2 or AM3"
    01 Personal Documents 0052 Voter's Registration Card
    01 Personal Documents 7998 W-116AA Mandatory Appointment Notice to Employment Vendor
    01 Personal Documents 7999 W-116CC Mandatory Return Appointment Notice to Employment Vendor
    01 Personal Documents 7926 W-116H Employment Appointment Notice
    01 Personal Documents 7927 W-116Q POISED Informational
    01 Personal Documents 6188 W-127H Authorized Representative Form
    01 Personal Documents 6803 W-133D Social Security Verification
    01 Personal Documents 6122 W-210X Primary Language Destination Form
    01 Personal Documents 6898 W-274E Summer Care Child Enrollment
    01 Personal Documents 8039 W-274H Children's Corner Registration Form
    01 Personal Documents 7915 W-507HH Notice of Appointment for Disapproved Training Program Review
    01 Personal Documents 1686 W-515D Alien Status Verifier
    01 Personal Documents 1856 W-560ZZ Application for Child-Only PA Child Case Payments
    01 Personal Documents 6130 W-607Q Referral for Photo Signature
    01 Personal Documents 6435 W-608T Request For EBT ID Card for Homebound Client
    01 Personal Documents 5001 W-608V ID Card Signature Authorization
    01 Personal Documents 1016 W-641 Verification of Request for Transportation School Pass
    01 Personal Documents 6806 W-680FF Language Questionnaire
    01 Personal Documents 7582 W-700E School Verification Letter
    01 Personal Documents 8621 W-763A HRA Request for Financial Management
    01 Personal Documents 8622 W-763C HRA Client Budget
    01 Personal Documents 8623 W-763T HRA Termination of Financial Management Services
    01 Personal Documents 8746 W-902F Child Care Worksheet/HASA
    01 Personal Documents 7795 W-904KK RTSC- Questionnaire for Minors in Residential Treatment
    10 Unscan Docs A116 40 Qtrs SSA Clearance documentation of work history only seen
    10 Unscan Docs A208 Adoption Subsidy check or copy seen
    10 Unscan Docs A106 Alimony or Support Money Order seen
    10 Unscan Docs A148 Alimony/Support check or copy seen
    10 Unscan Docs 0A86 Bills Submitted and Forwarded
    10 Unscan Docs A223 BOE Match on Address from CED seen
    10 Unscan Docs A152 Child Support check or copy seen
    10 Unscan Docs A102 Child Support Money Order seen
    10 Unscan Docs A110 Client Statement:Have Less Than a 7 Day Oil Supply
    10 Unscan Docs A229 Collateral Call Verifying Foster Care Information
    10 Unscan Docs 0A44 Contact with Friends
    10 Unscan Docs 0A36 Contact with Relatives
    10 Unscan Docs A221 Credit Card with Signature seen
    10 Unscan Docs 0A98 Cross- Machine Clearance Screen seen
    10 Unscan Docs A227 Current Contribution Check seen
    10 Unscan Docs A160 Dividends/Interest check or copy seen
    10 Unscan Docs A225 Home Visit Verifying household composition
    10 Unscan Docs A164 HUD Allowance check or copy seen
    10 Unscan Docs 0A9C Internal Clearance Screen seen
    10 Unscan Docs 6340 M-31a MAP/Other Payroll Match/Income Clearance Program
    10 Unscan Docs 1774 None Available
    10 Unscan Docs A216 Not Applicable
    10 Unscan Docs A168 NYS Disability check or copy seen
    10 Unscan Docs A226 Observation of obvious physical handicap seen
    10 Unscan Docs 0A04 Phone Call to Agency/Source
    10 Unscan Docs 0A12 Phone Call to Corrections Department
    10 Unscan Docs 0A00 Phone Call to Employer
    10 Unscan Docs 0A50 Phone Call to Facility or Listed in W145UU Temporary Housing Chart
    10 Unscan Docs A112 Phone Call to Financial Institution/Lender
    10 Unscan Docs 0A30 Phone Call to Former Employers
    10 Unscan Docs 0A38 Phone Call to Former Landlords
    10 Unscan Docs 0A42 Phone Call to Friends
    10 Unscan Docs 0A54 Phone Call to Medical Facility or M11Q Verified
    10 Unscan Docs 0A16 Phone Call to Medical Records Section of Hospital
    10 Unscan Docs 0A34 Phone Call to Relatives
    10 Unscan Docs 0A46 Phone Call to School Officials
    10 Unscan Docs 0A20 Phone Call to Shelter
    10 Unscan Docs 0A58 Phone Call to Union
    10 Unscan Docs 0A08 Phone Call to VA
    10 Unscan Docs 0A24 Phone Call to Welfare Agency/Program
    10 Unscan Docs 0A62 Processed form W314A
    10 Unscan Docs A214 Quarterly Estimated Tax seen
    10 Unscan Docs A172 Railroad Benefit check or copy seen
    10 Unscan Docs A104 Report to SSA office to correct info on file-NON DOCUMENT
    10 Unscan Docs A176 Retirement check or copy seen
    10 Unscan Docs 0A90 RFI Clearance Screen seen
    10 Unscan Docs A180 Savings Bonds seen
    10 Unscan Docs 0A94 SDX Clearance Screen seen
    10 Unscan Docs A184 Social Security check or copy seen
    10 Unscan Docs 0A74 SS card applied for and denied Non-Document
    10 Unscan Docs A103 SS card Applied for but no Proof submitted-Non-Document
    10 Unscan Docs 0A70 SS card not applied for-Non-Document
    10 Unscan Docs 0A66 SS5 submittted or Referred to SSA to correct demographic info
    10 Unscan Docs 0A9G SSA Verification Pending
    10 Unscan Docs A224 SSI Check or Copy seen
    10 Unscan Docs A212 Stock Certificates seen
    10 Unscan Docs A222 Subsidized Housing Collateral Clearance seen
    10 Unscan Docs A188 Tax Return Check or Copy seen
    10 Unscan Docs A213 Tax Return seen
    10 Unscan Docs A192 UIB check or copy seen
    10 Unscan Docs 0A78 Undocumented Alien
    10 Unscan Docs 0A82 Undomiciled
    10 Unscan Docs A196 Unoin Benefit check or copy seen
    10 Unscan Docs A200 VA check or copy seen
    10 Unscan Docs A220 Verbal Explanation for Job Refusal given unscannable
    10 Unscan Docs A228 W-2 Form seen
    10 Unscan Docs A204 Worker's Compensation check or copy seen
    11 Emp Docs 5097 Abbreviated Assessment form for PA Recipient in Treatment
    11 Emp Docs 6192 ACD 1068 Child Care Accident Report
    11 Emp Docs 7965 ACD 1069 Referral To Employer For Employee Income Information
    11 Emp Docs 6391 ACD 1513A Notice of Voucher Recert, Authorization and Fee Agreement
    11 Emp Docs 5948 ACD Referral to OES or BEGIN
    11 Emp Docs 7077 ACD-1069 Referral to Employer for Income Verification
    11 Emp Docs 5328 ACD-1082 Vocational Training Recertification
    11 Emp Docs 5713 ACD-60 Notice of Admission to Day Care Program
    11 Emp Docs 8094 ACS Recert Mail-In Packet
    11 Emp Docs 5099 AIS Assignment Information Summary
    11 Emp Docs 5101 Appointment Notice
    11 Emp Docs 5104 Archive Retrieval Tracking Form
    11 Emp Docs 5125 Assignment Information Summary Medical Limitation Alert
    11 Emp Docs 5126 Assignment Information SummaryNew YorkCityHumanResources Administration
    11 Emp Docs 5127 Attendance Form
    11 Emp Docs 5130 Authorization Employment Sanction OES
    11 Emp Docs 5131 Authorized Child Care Payments
    11 Emp Docs 8767 B2W Vendor SNAP Retention 180 milestone Packet
    11 Emp Docs 8732 B2W Vendor 180 Day Bonus with Wage Gain
    11 Emp Docs 8731 B2W Vendor 180 Day Retention
    11 Emp Docs 8730 B2W Vendor 90 Day Bonus with Case Closing
    11 Emp Docs 8729 B2W Vendor 90 Day Retention
    11 Emp Docs 8719 B2W Vendor Attendance Verification
    11 Emp Docs 8723 B2W Vendor Background Data
    11 Emp Docs 8720 B2W Vendor Education & Certificates
    11 Emp Docs 8734 B2W Vendor EITC Verification
    11 Emp Docs 8724 B2W Vendor Employment Plan or Post Employment
    11 Emp Docs 8721 B2W Vendor Employment Verification
    11 Emp Docs 8733 B2W Vendor EXCUSED Absence Documentation
    11 Emp Docs 8726 B2W Vendor Initial Placement 30days
    11 Emp Docs 8727 B2W Vendor Initial Placement Supplement Time limit and Sanctioned
    11 Emp Docs 8736 B2W Vendor ITA Approved Voucher
    11 Emp Docs 8722 B2W Vendor ITA separate application
    11 Emp Docs 8737 B2W Vendor ITA Survey Form
    11 Emp Docs 8728 B2W Vendor Post Employment Plan
    11 Emp Docs 8725 B2W Vendor Pre Employment Plan
    11 Emp Docs 8760 B2W Vendor SNAP Alcohol or Drug Treatment Assessment Packet
    11 Emp Docs 8764 B2W Vendor SNAP Assignment Assessment Packet
    11 Emp Docs 8761 B2W Vendor SNAP Child Under 18 Assessment Packet
    11 Emp Docs 8765 B2W Vendor SNAP Employment Placement Assessment Packet
    11 Emp Docs 8758 B2W Vendor SNAP Full Time Student Assessment Packet
    11 Emp Docs 8763 B2W Vendor SNAP In-kind Hours Reported Assessment Packet
    11 Emp Docs 8756 B2W Vendor SNAP Medical or Mental Assessment Packet
    11 Emp Docs 8757 B2W Vendor SNAP Needed in Home Assessment Packet
    11 Emp Docs 8759 B2W Vendor SNAP Pregnancy Verification Assessment Packet
    11 Emp Docs 8755 B2W Vendor SNAP Refugee Status Package
    11 Emp Docs 8766 B2W Vendor SNAP Retention 90 milestone Packet
    11 Emp Docs 8762 B2W Vendor SNAP Unemployment Benefits Assessment Packet
    11 Emp Docs 8769 B2W Vendor STEP Employment Assessment Packet
    11 Emp Docs 8770 B2W Vendor STEP Employment Placement
    11 Emp Docs 8768 B2W Vendor STEP OCSE Evaluation
    11 Emp Docs 8772 B2W Vendor STEP Retention 180 milestone Packet
    11 Emp Docs 8771 B2W Vendor STEP Retention 90 milestone Packet
    11 Emp Docs 8738 B2W Vendor Substance Abuse Treatment Verification
    11 Emp Docs 8735 B2W Vendor Training ITA or Vocational Attendance Documentation
    11 Emp Docs 7789 Begin Change of Worksite Request Form
    11 Emp Docs 7544 Begin Participant Worksite Evaluation Mid-Point
    11 Emp Docs 8219 BFI Employment E-30 Packet
    11 Emp Docs 8436 BFI-130 Payroll Inquiry Form
    11 Emp Docs 7817 BTW Vendor 180 Day Bonus with Wage Gain
    11 Emp Docs 7816 BTW Vendor 180 Day Retention
    11 Emp Docs 7815 BTW Vendor 90 Day Bonus with Case Closing
    11 Emp Docs 7814 BTW Vendor 90 Day Retention
    11 Emp Docs 7547 BTW Vendor Attendance Verification
    11 Emp Docs 7819 BTW Vendor EITC Verification
    11 Emp Docs 7549 BTW Vendor Employment Verification
    11 Emp Docs 7818 BTW Vendor EXCUSED Absence Documentation
    11 Emp Docs 7811 BTW Vendor Initial Placement 30days
    11 Emp Docs 7812 BTW Vendor Initial Placement Supplement Time limit and Sanctioned
    11 Emp Docs 7821 BTW Vendor ITA Approved Voucher
    11 Emp Docs 7822 BTW Vendor ITA Survey Form
    11 Emp Docs 7813 BTW Vendor Post Employment Plan
    11 Emp Docs 7810 BTW Vendor Pre Employment Plan
    11 Emp Docs 7823 BTW Vendor Substance Abuse Treatment Verification
    11 Emp Docs 7820 BTW Vendor Training ITA or Vocational Attendance Documentation
    11 Emp Docs 6190 Business Card or Photocopy of a business card
    11 Emp Docs 5137 Care Required by Sick or Disabled Household Member
    11 Emp Docs 5834 Carfare Authorization
    11 Emp Docs 5139 Carfare Calculation Worksheet For School Training
    11 Emp Docs 8812 CAS-500 Mandatory Appointment for Evaluation of Work Activity
    11 Emp Docs 5946 Cases Identified for Non-Compliance PRIDE
    11 Emp Docs 5142 CEOSC Referral Letter
    11 Emp Docs 5143 Certificate of Attendance at a Funeral Service
    11 Emp Docs 5944 Checklist for PRIDE
    11 Emp Docs 5146 Child Care Advance
    11 Emp Docs 5828 Child Care in New York City
    11 Emp Docs 5149 Child Care Payment Transmittal Form
    11 Emp Docs 5150 Child Care Payment-Request Return
    11 Emp Docs 5151 Child Care Payments - Memorandum
    11 Emp Docs 5152 Child Care Plan BEGIN
    11 Emp Docs 5153 Child Care Provider of Participant Termination Notice to
    11 Emp Docs 5159 Childcare Calculation Worksheet for school-training
    11 Emp Docs 5163 CIF Client Information Form any kind
    11 Emp Docs 5168 Client Rights and Responsibilities
    11 Emp Docs 5170 Clients Enrolling in Employment Programs Notice to
    11 Emp Docs 5179 Conciliation Notice any kind
    11 Emp Docs 5189 Consent for Disclosure of Medical Records from Alcohol and Drugs
    11 Emp Docs 5939 Consent to Disclosure of Records
    11 Emp Docs 5190 Contract BEGIN
    11 Emp Docs 5219 CS-574EE Fact Sheet-Child Care in New York City
    11 Emp Docs 7172 Documentation certifying need for licensing/uniform/durable goods fees
    11 Emp Docs 7374 Documentation certifying need for work-activity related request
    11 Emp Docs 5197 DOH Licensed Child Care Provider Verification
    11 Emp Docs 8225 DOH-4444 Self-Declaration of Income
    11 Emp Docs 8226 DOH-5017 Verification of Employment
    11 Emp Docs 5180 DSS-1230 Conciliation Notification
    11 Emp Docs 5980 DSS-1653 Certificate of Employability
    11 Emp Docs 7193 DSS-2236 Employment Clearance
    11 Emp Docs 6070 DSS-2355 Medical Report Employment
    11 Emp Docs 6035 DSS-2643 Foster Home - Certificate to Board Children
    11 Emp Docs 5140 DSS-3023 Central Report
    11 Emp Docs 6067 DSS-3377 Mandatory Eye Examination Report
    11 Emp Docs 5263 DSS-3573 New Recoupment
    11 Emp Docs 5255 DSS-3696 Job Search Handbook 15 pages 2 sided
    11 Emp Docs 6018 DSS-3707 Employment Verification
    11 Emp Docs 5196 DSS-3948 Disability Claim Questionnaire-3 pages
    11 Emp Docs 5181 DSS-4230 Conciliation Notification
    11 Emp Docs 8017 DSS-Pre Employment Application
    11 Emp Docs 8357 EIP/SEI Statement of understanding
    11 Emp Docs 5201 Employability Cover Letter Notification of
    11 Emp Docs 7372 Employer Letter showing valid offer of employment
    11 Emp Docs 7477 Employer's letterhead w phone Hrly rate wkly hrs new first pay date
    11 Emp Docs 5415 Employment Appointment Letter
    11 Emp Docs 5204 Employment Documentation
    11 Emp Docs 5205 Employment History Sheet any kind
    11 Emp Docs 8340 Employment Incentives Plus
    11 Emp Docs 5206 Employment Plan
    11 Emp Docs 7473 Employment Services Packet Begin Internship Program
    11 Emp Docs 7474 Employment Services Packet Begin Language Study
    11 Emp Docs 7475 Employment Services Packet Begin Work Study
    11 Emp Docs 7471 Employment Services Packet Employment Contractor Services
    11 Emp Docs 7472 Employment Services Packet Employment Processing Unit EPU
    11 Emp Docs 7470 Employment Services Packet Job Opportunity Grant Diversion JOP or GD
    11 Emp Docs 7469 Employment Services Packet Training Assessment group TAG or team
    11 Emp Docs 7589 Employment Services Packet: Verification of GPA letter COPE Program
    11 Emp Docs 8718 Employment Verification Document ? 180 days
    11 Emp Docs 8716 Employment Verification Document ? 30 days
    11 Emp Docs 8717 Employment Verification Document ? 90 days
    11 Emp Docs 5214 EPFT Benefit Data Entry Form OES
    11 Emp Docs 5216 Exam for Emp Assess Disability Screening AD Addiction Determination
    11 Emp Docs 8083 Excused Hours Documentation
    11 Emp Docs 5218 Exemption from WEP
    11 Emp Docs 6937 EXP-76A Community Solutions for Trans/MIP Grant Checklist
    11 Emp Docs 6938 EXP-76C Metro card Issuance Approval Form
    11 Emp Docs 6950 EXP-76E Interim Training Assessment Form
    11 Emp Docs 7402 EXP-76G JTP Participant Statement of Understanding
    11 Emp Docs 7663 EXP-80R PARKS Job Offer
    11 Emp Docs 7938 EXP-84EE Job Fair Notice
    11 Emp Docs 8018 EXP-85K Notice of Job Interview
    11 Emp Docs 8233 F401 90 Day Retention Packet
    11 Emp Docs 8234 F501 90 Day Retention with Case Closing Packet
    11 Emp Docs 8235 F601 180 Day Retention Packet
    11 Emp Docs 8236 F701 180 Day Retention w/Wage Gain Packet
    11 Emp Docs 5220 Failure to Cooperate
    11 Emp Docs 8458 FIA-1056 Action Taken for Replacement of Food Purchased with FS
    11 Emp Docs 8482 FIA-1064 Understanding What Will Take Place At My TAG Appointment
    11 Emp Docs 8693 FIA-1086 Transition to Back to Work (B2W) Vendor
    11 Emp Docs 8694 FIA-1086b Information About Your Literacy Services (BTW)
    11 Emp Docs 8754 FIA-1086h Appointment with HRA Staff at Back to Work (B2W)
    11 Emp Docs 8790 FIA-1092 Important Notice
    11 Emp Docs 8808 FIA-1095a NCA WEP Carfare Log
    11 Emp Docs 8457 FSE BTW Employment Declaration Package
    11 Emp Docs 8189 FSE Refugee Status Package
    11 Emp Docs 8099 FSE Vendor Alcohol or Drug Treatment Assessment Packet
    11 Emp Docs 8100 FSE Vendor Child Under 18 Assessment Packet
    11 Emp Docs 8105 FSE Vendor Employment Placement Assessment Packet
    11 Emp Docs 8103 FSE Vendor Employment Plan Assignment Assessment Packet
    11 Emp Docs 8097 FSE Vendor Full Time Student Assessment Packet
    11 Emp Docs 8102 FSE Vendor In-kind Hours Reported Assessment Packet
    11 Emp Docs 8095 FSE Vendor Medical or Mental Assessment Packet
    11 Emp Docs 8096 FSE Vendor Needed in Home Assessment Packet
    11 Emp Docs 8108 FSE Vendor Post Retention 180 milestone Packet
    11 Emp Docs 8107 FSE Vendor Post Retention 90 milestone Packet
    11 Emp Docs 8106 FSE Vendor Post Retention Packet
    11 Emp Docs 8104 FSE Vendor Post Retention Plan Assessment Packet
    11 Emp Docs 8098 FSE Vendor Pregnancy Verification Assessment Packet
    11 Emp Docs 8101 FSE Vendor Unemployment Benefits Assessment Packet
    11 Emp Docs 8386 FSE/BTW 100j Package
    11 Emp Docs 5232 HRA Medical Examination
    11 Emp Docs 5234 HRA Pride 2000 Client Record
    11 Emp Docs 5236 Human Resources Administration Employment Questionnaire
    11 Emp Docs 5238 Increased WEP Hours and Child Care Requirements Notification of
    11 Emp Docs 5239 Individual Education Program
    11 Emp Docs 8063 Individual Plan of Employment
    11 Emp Docs 5240 Information Request Letter
    11 Emp Docs 5241 Initial Child Care Provider Letter
    11 Emp Docs 5242 Inquiry Form
    11 Emp Docs 5246 Internal Questionnaire
    11 Emp Docs 5247 Internship Referral Letter
    11 Emp Docs 5832 Job Center Routing Form
    11 Emp Docs 5256 Licensed Child Care Provider Liaison Unit Inquiry Form
    11 Emp Docs 5257 Licensed Child Care Provider Unit Form
    11 Emp Docs 5258 Licensed Day Care Provider of Termination Notice to
    11 Emp Docs 6218 List of addresses and or phone numbers
    11 Emp Docs 5266 M-160 Original or Copy of Checks Request for
    11 Emp Docs 5267 M-160J Request for Original or Copy of Checks
    11 Emp Docs 7962 M-183b Wage and Health Benefits Report
    11 Emp Docs 6143 M-22b Request for information on child 16 years of age and over
    11 Emp Docs 6972 M-327a Self-Sufficiency case progress review
    11 Emp Docs 7231 M-528J Child Care Appointment Notice
    11 Emp Docs 5165 M-623a Client of Housing Services Subsidy Notice to
    11 Emp Docs 7020 M-696a Plan of Self Support
    11 Emp Docs 7021 M-696b Plan of Self Support Agreement for Medicaid
    11 Emp Docs 7022 M-696c Plan of Self-Support Agreement for Public Assistance
    11 Emp Docs 5209 M-6h Employment Related Case Closing or Reduction
    11 Emp Docs 8742 M-75q B2W Special Shelter Initiative H Voluntary Assignment
    11 Emp Docs 5260 Master List of Training Programs OES Resource Development
    11 Emp Docs 5261 Medical Assessment Request for
    11 Emp Docs 5262 Miscellaneous Employment Documentation
    11 Emp Docs 6076 Notice of Appeal for Predetermination of Eligibility for Day Care
    11 Emp Docs 6083 Notice of Eligibility and Day Care Service & Fee Agreement
    11 Emp Docs 6084 Notice of Eligibility Authorization for Voucher for Day Care Service
    11 Emp Docs 6088 Notice of Intent to Discontinue Day Care
    11 Emp Docs 6089 Notice of Intent to Discontinue Day Care
    11 Emp Docs 8358 Notice of Termination or Rollover- EIP/SEI
    11 Emp Docs 1262 OES-3A Job Notice
    11 Emp Docs 5970 OES-4 Begin Work Study Attendance Policy Agreement
    11 Emp Docs 5138 OES-4N Career Planning Training Letter
    11 Emp Docs 5271 OES-4Q Participant Referral to Job Site
    11 Emp Docs 5292 OES-4T Referral Outcome Report BEGIN
    11 Emp Docs 5225 OES-4X HR Job Search PA & FS Job Search Participant Rights and Resp
    11 Emp Docs 5268 Parental Choice Declaration
    11 Emp Docs 5272 Participant's Rights and Responsibilities
    11 Emp Docs 5273 Participation Agreement
    11 Emp Docs 5275 Participation Program Summary BEGIN
    11 Emp Docs 5276 Payment Inquiry Review
    11 Emp Docs 5277 Payment Verification Form
    11 Emp Docs 8525 POISED PACKET
    11 Emp Docs 5938 PRIDE 2000 Referral Letter or PRIDE Assessment Referral Letter
    11 Emp Docs 5940 PRIDE Client Record
    11 Emp Docs 5282 Program Participant Statement of Understanding-Training & Employment Assistance
    11 Emp Docs 5284 Provider Requst Conclusion
    11 Emp Docs 5285 Providers information Not Found at BEGIN Letter to
    11 Emp Docs 5286 Quick Service
    11 Emp Docs 5288 Quick Service Prescreening Form
    11 Emp Docs 5289 Recertification Worksheet
    11 Emp Docs 8392 Recruiting / Referral - Employment Service
    11 Emp Docs 5291 Recurring Allowance Authorization Form
    11 Emp Docs 5293 Referral to ACD for Day Care Services OES
    11 Emp Docs 5920 Referral to Employer for Employee Information
    11 Emp Docs 5294 Referral to Employment Center
    11 Emp Docs 5297 Referral to Office of Employment Services-Job Readiness
    11 Emp Docs 5303 Sanction and Transmittal BEGIN
    11 Emp Docs 5304 Sanction TAD Transmittal-BEGIN
    11 Emp Docs 5309 Single Issue Transmittal
    11 Emp Docs 8740 SNAP B2W Employment Declaration Package
    11 Emp Docs 8739 SNAP/B2W 100j Package
    11 Emp Docs 5311 Student Information Release Form
    11 Emp Docs 8341 Subsidized Employment Initiative
    11 Emp Docs 5312 Substance Abuse Client History
    11 Emp Docs 5313 Summary of Proceedings
    11 Emp Docs 5314 Suspension letter
    11 Emp Docs 8249 TEAM TAG Training Verification Document Packet
    11 Emp Docs 5315 Temporarily Unemployable Notice of
    11 Emp Docs 5316 Testing Center Referral Letter
    11 Emp Docs 8082 Timekeeping Sheets
    11 Emp Docs 5317 Training & Employment Assistance Program Participant Statement of Understanding
    11 Emp Docs 5322 TRE Reconsideration Request
    11 Emp Docs 5323 Tre Termination Letter-Employment
    11 Emp Docs 5324 Tre Termination Letter-Non Compliance Notification
    11 Emp Docs 7422 UIB Monetary Determination Letters
    11 Emp Docs 7478 UIB Notice of Determination of Ineligibility or Disqualification
    11 Emp Docs 5326 Up-Front Verification/Initial Case Report
    11 Emp Docs 8151 Verification of Absence from Program-PCS
    11 Emp Docs 5327 Verification of Student Work Schedule
    11 Emp Docs 5329 Voluntary Participation Agreement
    11 Emp Docs 7993 W-100C Barrier to Employment Form
    11 Emp Docs 7994 W-100E De-assignment Letter
    11 Emp Docs 7995 W-100F Food Stamp Employment and Training Employability Assessment
    11 Emp Docs 7996 W-100H Loss of Employment Form
    11 Emp Docs 7997 W-116BB Assignment Letter
    11 Emp Docs 6666 W-116G Notice of Job Placement
    11 Emp Docs 8210 W-116HH Employment Verification Form
    11 Emp Docs 7233 W-116P Mandatory Job Search Business Link Appointment
    11 Emp Docs 5227 W-132T Households with Authorized Representatives, Notice to
    11 Emp Docs 5208 W-167C Employment Referral
    11 Emp Docs 6094 W-2-114 Notice of No Carfare
    11 Emp Docs 6111 W-2-17 Office of Employment Services OES Child
    11 Emp Docs 5192 W-2-173A Declaration of Employment
    11 Emp Docs 5299 W-2-229G Reminder Letter BEGIN
    11 Emp Docs 5231 W-2-244 HRA Letterhead-Family Support Administration MAP
    11 Emp Docs 5233 W-218 HRA Memo
    11 Emp Docs 5176 W-25 C Conciliation History Sheet
    11 Emp Docs 5186 W-25F Conference History Sheet
    11 Emp Docs 5187 W-26 Conference History Sheet
    11 Emp Docs 6039 W-273D How to fill out the Child Care Provider Form CCPF
    11 Emp Docs 6193 W-273J Child Care Provider Contact List
    11 Emp Docs 6055 W-273K Initial Child Care Payment Authorization Form
    11 Emp Docs 7936 W-274CC Child Care Enrollment Call-In Notice
    11 Emp Docs 7612 W-274X Securing a Child Care Provider Prior to Recertification
    11 Emp Docs 5193 W-278 Declaration of Employment
    11 Emp Docs 6000 W-28A Continuation Sheet
    11 Emp Docs 8483 W-300 Referral to Wellness-Employment (WeCare) for a Clinical Review
    11 Emp Docs 7968 W-331Q Disability Services Program Return Appointment
    11 Emp Docs 7486 W-331W Disability Services Prgrm Mandatory Assessment Interview
    11 Emp Docs 7937 W-333G Child Care Enrollment Call-In Notice
    11 Emp Docs 6144 W-344 Request for Leave
    11 Emp Docs 6169 W-347 Weekly Time Control
    11 Emp Docs 6173 W-364 Work Experience Program WEP Referral to Worksite
    11 Emp Docs 6538 W-364A New Start WEP Determination Form
    11 Emp Docs 5318 W-456U-A Training and Employment Assistant Program Summary Plan
    11 Emp Docs 7235 W-500X Time Limits Eligib Rev Appoint Notice for Sanction HH
    11 Emp Docs 7236 W-500Y Mandatory POISED Assessment Appointment
    11 Emp Docs 8741 W-502 Referral to Back 2 Work B2W Vendor
    11 Emp Docs 6955 W-507 Mandatory Training Assessment Group Appointment
    11 Emp Docs 7966 W-516E Real Property Tax Credit Notice
    11 Emp Docs 7967 W-516G New York State Nutrition Incentive Program RPTCN
    11 Emp Docs 5110 W-521D Assignment Information Summary ADC Referral
    11 Emp Docs 5955 W-532K Agreement to Comply with Employment Program Requirements
    11 Emp Docs 7239 W-533G WeCARE Nonmedical Referral for Mandatory Services
    11 Emp Docs 5279 W-537D Physician's Assessment of Client's Employability
    11 Emp Docs 6016 W-541B Employment Record
    11 Emp Docs 6131 W-548A Referral to ACD for Day Care Services
    11 Emp Docs 5336 W-550R-M Work Compliance Referral
    11 Emp Docs 6104 W-555C Notification of Report of Child Abuse or Maltreatment
    11 Emp Docs 6108 W-559B NYC WAY
    11 Emp Docs 6393 W-560J Work Related Benefits Program Monthly Voucher
    11 Emp Docs 6653 W-560U Request for Information from Employer
    11 Emp Docs 5169 W-564 Client's Employability
    11 Emp Docs 5278 W-565B Personal Questionnaire
    11 Emp Docs 5338 W-565C Work Experience Program Regulations
    11 Emp Docs 5305 W-568 Scheduled for an Appointment at the WEP
    11 Emp Docs 5166 W-568B Client Request for Review of Employability Status
    11 Emp Docs 5167 W-568E Client Request for Review of Employability Status.Train
    11 Emp Docs 6139 W-568K Request for Exemption - Review of Employability Status
    11 Emp Docs 5129 W-568Q Attendance Verification Letter
    11 Emp Docs 5245 W-568U Intent to Change Continue Ben PA-FS-MA Cov and Serv Notice of
    11 Emp Docs 5178 W-569C Conciliation Notice
    11 Emp Docs 5995 W-570 Component Enrollment
    11 Emp Docs 5957 W-570A Allowance Worksheet
    11 Emp Docs 5188 W-570L Confirmation of New Appointment
    11 Emp Docs 5171 W-570P Clients Enrolling in School and Training-Prog Notice to
    11 Emp Docs 6117 W-570T Participant Attendance Card
    11 Emp Docs 5194 W-570Y Degree Granting College Tre-Application
    11 Emp Docs 5270 W-572E Participant Change of Status Report
    11 Emp Docs 5339 W-572N Work Experience Program Regulations and Attendance Policy
    11 Emp Docs 5243 W-573 Intake Referral BEGIN
    11 Emp Docs 5343 W-573BB Work Study Referral Letter
    11 Emp Docs 5202 W-573D Employability Development Plan BEGIN
    11 Emp Docs 5249 W-573F Job Club Evaluation BEGIN
    11 Emp Docs 6057 W-573Q Intake Re-evaluation form BEGIN
    11 Emp Docs 5124 W-573R Assignment Information Summary BEGIN Work Study Program
    11 Emp Docs 6168 W-573RR Verification of Student Work Schedule
    11 Emp Docs 6110 W-574D Office of Employment Services OES
    11 Emp Docs 5161 W-574FF Proof of ID For Your Child Care Provider or Babysitter
    11 Emp Docs 6174 W-574HH Work Study Referral Letter
    11 Emp Docs 5164 W-574Q Client Information Form NYC WAY
    11 Emp Docs 5162 W-574XX CIF Client Information Form
    11 Emp Docs 5133 W-576-N Authorized OES Case Reopening Action
    11 Emp Docs 5298 W-576J Referral to Resource Development
    11 Emp Docs 5213 W-576K Employment Notification of
    11 Emp Docs 5203 W-576N Employability Plan Background Info BEGIN
    11 Emp Docs 5244 W-576Q Intent to Change PA Grant FS-MA for Non-Compl w Empt-Rel Reqs
    11 Emp Docs 5217 W-576U Excuse Form For WEP Participants Arranging Child Care
    11 Emp Docs 5109 W-577 Assignment Information Summary
    11 Emp Docs 5123 W-578UU Assignment Information Summary Standard OES
    11 Emp Docs 6257 W-580AA To be Completed by Individual Providing Chid Care
    11 Emp Docs 5222 W-582A Family Care Assessment
    11 Emp Docs 5207 W-584A Employment Plan NYC WAY BEGIN
    11 Emp Docs 7237 W-584K Mandatory Appointment for Evaluation of Work Activity
    11 Emp Docs 7238 W-584M Reevaluation of Employability Status Appointment
    11 Emp Docs 6942 W-592G Employment and Wage Verification Form
    11 Emp Docs 7035 W-592Q Employment and Wage Verification Form
    11 Emp Docs 6116 W-667A Parent's Checklist for Group Day Care
    11 Emp Docs 5147 W-667C Child Care Confirmation Form
    11 Emp Docs 5148 W-667C Lic Child Care Confirmation Form Lic Reg Child Care
    11 Emp Docs 6061 W-667H Job Center Carfare Request
    11 Emp Docs 6132 W-680CC Referral to FIA Employment
    11 Emp Docs 5989 W-687C Child Care Single Issuance Authorization
    11 Emp Docs 5693 W-700D FIA School or Training Enrollment Letter
    11 Emp Docs 5976 W-719G Carfare Authorization
    11 Emp Docs 5945 Waiver Evaluation/Services Referral PRIDE
    11 Emp Docs 8150 WEM Attendance Documents Package-Attendance Docs-Discretionary Form
    11 Emp Docs 8153 WEM Employment Verification Documents-Paystub-Job Letter-FIA3a-PCS
    11 Emp Docs 8154 WEM Medical Exemption-Documents Claiming Medical Exemption
    11 Emp Docs 8149 WEM School/Training Package-School Verifications-PCS Form
    11 Emp Docs 8152 WEM Unemployment Insurance Determinations-UIB Documents-PCS
    11 Emp Docs 5330 WEP Assignment Worksheet for College TANF Clients
    11 Emp Docs 8155 WEP Incidents/Documentations-PCS
    11 Emp Docs 6179 WEP or AVU Roster
    11 Emp Docs 5331 WEP Participant Termination from Assignment Report OES
    11 Emp Docs 5332 WEP Participant's Timesheet
    11 Emp Docs 5333 Withdrawal Notice of
    11 Emp Docs 5342 Work Accountability and You WAY Activity Inquiry
    11 Emp Docs 5335 Work Assignment Sheet-College TANF Clients BA
    11 Emp Docs 5337 Work Experience Program Participant Termination From OES
    11 Emp Docs 5340 Work Study Referral Letter
    11 Emp Docs 5341 Work Study Transfer Form BEGIN
    11 Emp Docs 5223 Year Final Semester Request for Exempt From OES Mandated Activities
    12 Fd Stamps 6106 2002C-Map
    12 Fd Stamps 5349 Application Worksheet
    12 Fd Stamps 5353 Budget Entry Supervisor Summary
    12 Fd Stamps 8803 CAS-201 Authorization for Medicaid Record
    12 Fd Stamps 5354 Case Composition
    12 Fd Stamps 5355 Case Summary
    12 Fd Stamps 7192 CCF1 Claims Control Form
    12 Fd Stamps 5356 Change Group History
    12 Fd Stamps 5357 Check Copy-US Treasury
    12 Fd Stamps 5358 Claimant Correspondence
    12 Fd Stamps 5359 Clearance Report
    12 Fd Stamps 5410 CNS-Supervisory Review Report
    12 Fd Stamps 5361 Continuing Eligibility Determination Worksheet for NPA
    12 Fd Stamps 6635 DFS-37
    12 Fd Stamps 5364 Documentation Request
    12 Fd Stamps 8701 DSNAP Packet
    12 Fd Stamps 5961 DSS-179-2 Application for Food Stamps - Part 2
    12 Fd Stamps 5370 DSS-3035 FS Appt for SSO Recipients and Group Living Residents
    12 Fd Stamps 5374 DSS-3151 Food Stamp Change Report Form 2 pages 2 sided
    12 Fd Stamps 5379 DSS-3574 Food Stamp Single Issuance Authorization Form
    12 Fd Stamps 5352 DSS-3577 Batch Transmittal
    12 Fd Stamps 5385 DSS-3620 Notice of Intent to Change FS Benefits
    12 Fd Stamps 5384 DSS-3621 Notice of Intent to Change FS Benefits Adequate Only
    12 Fd Stamps 7093 DSS-4053 Food Stamp Repayment Agreement
    12 Fd Stamps 6114 DSS-4310 PA and Food Stamp Document
    12 Fd Stamps 5412 DSS-4482/30 Transmittal of Fair Hearing Decision to DSS Agency
    12 Fd Stamps 6970 DSS-4753 Food Stamps-request for contact or missed interview
    12 Fd Stamps 6010 EBT Balance Inquiry
    12 Fd Stamps 6637 EBT-32
    12 Fd Stamps 5366 Eligibility Determination Worksheet
    12 Fd Stamps 7799 EXP-84K Letter to Food Stamp Enrollees
    12 Fd Stamps 5363 F-15 Discrepant Eligibility Information Tracking Form
    12 Fd Stamps 8518 FIA-1062 Important Notice to Food Stamp Participants
    12 Fd Stamps 8519 FIA-1063 SNAP Employment and Training/Enrollment/Consent Form
    12 Fd Stamps 8700 FIA-1088a Denial of your Request for a SNAP Benefit Supplement
    12 Fd Stamps 8774 FIA-1088b Receipt for (DSNAP) Application
    12 Fd Stamps 8775 FIA-1088d Questions and Answers on (DSNAP)
    12 Fd Stamps 8773 FIA-1090 DSNAP Information Document
    12 Fd Stamps 5373 Food Stamp Center 44 Flushing Recertification Questionnaire
    12 Fd Stamps 5375 Food Stamp Documentation any kind
    12 Fd Stamps 5376 Food Stamp Eligibility Decision for Legal Resident Non-Citizens Notice of
    12 Fd Stamps 5377 Food Stamp Issuance
    12 Fd Stamps 8324 Food Stamp Online Application Summary Access NYC
    12 Fd Stamps 8191 Food Stamp Online Application Summary myBenefits
    12 Fd Stamps 7870 Food Stamp Telephone Recertification Interview Guide
    12 Fd Stamps 5380 Food Stamps Budget Calculation
    12 Fd Stamps 6581 Food Stamps Pre-Screening Form
    12 Fd Stamps 5381 Help With Expenses Request Proof of
    12 Fd Stamps 6584 History Sheet - FS Overpayment Claim History Sheet
    12 Fd Stamps 5382 Human Resource SDX Extract NYC
    12 Fd Stamps 7871 Incomplete Food Stamp Recertification Form
    12 Fd Stamps 5386 International Money Order
    12 Fd Stamps 6939 LDSS-2291 Request For Replace Food Purchased With FS Benefits
    12 Fd Stamps 5345 LDSS-3152 Action Taken on Your Food Stamp Case
    12 Fd Stamps 6957 LDSS-3513 FS Recoupment Data Entry Form-WMS
    12 Fd Stamps 7514 LDSS-3938 FS Application Expedited Processing Summary Sheet
    12 Fd Stamps 6922 LDSS-4826 Food Stamp Benefits Application
    12 Fd Stamps 7240 LDSS-4836 NYSIP 24-Month Interim Report NYC
    12 Fd Stamps 7143 LDSS-4841 NYSNIP Food Stamp Case Information Collection Sheet
    12 Fd Stamps 8110 LDSS-4942 Food Stamp Program Authorized Representative Request Form
    12 Fd Stamps 8696 LDSS-4988 Applic For Disaster Supplemental Nutrition Assist Program
    12 Fd Stamps 8695 LDSS-4989 Disaster Supplemental Nutrition Assistance Program Case
    12 Fd Stamps 6760 M-321a Food Stamp Recertification
    12 Fd Stamps 6759 M-321e Food Stamp Recertification Packets
    12 Fd Stamps 8014 M-328c Notice to Participant Restriction of Renr Payment
    12 Fd Stamps 5344 M-4d Action Taken in Compliance with a Fair Hearing Decision
    12 Fd Stamps 7869 Non-Response to Telelphone Recertification Notice
    12 Fd Stamps 5394 NPA Food Stamp Pre-Screening Form
    12 Fd Stamps 8092 PA-FS Grant Profile Report
    12 Fd Stamps 5396 Payee of Rent not Resident Letter From
    12 Fd Stamps 8355 POS Budget Letter for NCA Food Stamp Case
    12 Fd Stamps 5397 Prescription Slips
    12 Fd Stamps 5398 Recoupment Menu
    12 Fd Stamps 5400 Rent Change Notice
    12 Fd Stamps 5401 Retroactive Unit Report of Action Taken on a Fair Hearing Decision
    12 Fd Stamps 5402 Roommate Letter
    12 Fd Stamps 5405 SDX Inquiry
    12 Fd Stamps 6621 Social Security Report or Individual Sheet mixed Food Stamps H-H 1B
    12 Fd Stamps 6252 SSA-4233 SSA Transmittal for Food Stamp Application
    12 Fd Stamps 5409 Sublease Agreement Renewal
    12 Fd Stamps 5411 Supplemental Security Income Change in Payment Notice of
    12 Fd Stamps 7195 Treasury Offset Program TOP Client Appeal Review Worksheet 4 pages
    12 Fd Stamps 8047 W-100J Food Stamp Employment Declaration
    12 Fd Stamps 8048 W-100K Claim of In-Kind Work
    12 Fd Stamps 6665 W-102C FA or MA Recertification Form
    12 Fd Stamps 5413 W-112H Wage Reporting and Unemployment Insurance Clearance
    12 Fd Stamps 6398 W-119A Food Stamp Application Control Card
    12 Fd Stamps 8041 W-119D Eligibility Factors and Suggested Documention Guide
    12 Fd Stamps 7568 W-120 Food Stamp Benefits Application Signature Form
    12 Fd Stamps 5365 W-120D Documents Received Required Notice of
    12 Fd Stamps 6744 W-120D Notice of Documentation Required
    12 Fd Stamps 6399 W-120K HRA Income Support Programs Food Stamp Program
    12 Fd Stamps 6634 W-122A Monthly Food Stamps Worksheet
    12 Fd Stamps 5389 W-122AA Monthly Food Stamp Worksheet
    12 Fd Stamps 5369 W-127C Food Stamp Application Statement 2 sheets 4 pages
    12 Fd Stamps 5406 W-127NP Important Notice to Food Stamp Applicants Participants
    12 Fd Stamps 7777 W-129A FS Eligibility Interview Telephone Appointment Notice
    12 Fd Stamps 7778 W-129B FS Benefits Application Attestation Signature Form
    12 Fd Stamps 5371 W-129BB-CC Food Stamp Authorization Form - Mail
    12 Fd Stamps 5391 W-129CC NPA Food Stamp Authorization Form-Mail
    12 Fd Stamps 6159 W-129E Submission of information to Food Stamp Program
    12 Fd Stamps 6818 W-129RR Important Notice of Recertification Appointment
    12 Fd Stamps 7066 W-129U Food Stamp Budget Worksheet
    12 Fd Stamps 6031 W-129Y Food Stamp Authorization Form - in person
    12 Fd Stamps 7678 W-130G Action Taken on Replacement of FS Stolen from EBT
    12 Fd Stamps 5393 W-130G NPA Food Stamp Authorization Form
    12 Fd Stamps 6034 W-131B Food Stamp Notice of Expiration
    12 Fd Stamps 6107 W-132AA NPA FS History Employment Recor -12 mos prior to application
    12 Fd Stamps 5387 W-132B Ledger Record of FS Authorizations
    12 Fd Stamps 7080 W-132R ABAWD Tracking Log
    12 Fd Stamps 5982 W-132W Change Report Form for food stamp program 4 pgs
    12 Fd Stamps 5378 W-132X Food Stamp Recertification Worksheet 2 pages 2 sided
    12 Fd Stamps 6526 W-133BB Important Food Stamp Notice
    12 Fd Stamps 5360 W-133D Clearance Report on SSI Food Stamp Cases
    12 Fd Stamps 5346 W-133J Additional Information to Complete FS Application, Rqst
    12 Fd Stamps 5408 W-133N SSI Office Case Summary
    12 Fd Stamps 5404 W-133P Routing Form
    12 Fd Stamps 5368 W-134X Evaluation of FS Eligibility Decision by Legal Resident
    12 Fd Stamps 6636 W-138NN NPA-Computer Match Worksheet
    12 Fd Stamps 5350 W-138PP Appointment for Recertification Interview Notice of
    12 Fd Stamps 5348 W-138XX All Food Stamp Recipients Notice of
    12 Fd Stamps 5351 W-140A Attention Brooklyn and Queens Food Stamp Clients
    12 Fd Stamps 6314 W-140CC New Claims Prescreening Form
    12 Fd Stamps 8405 W-140EE Report of Claims Determination Transmittal
    12 Fd Stamps 6633 W-140GG Letter of Employer
    12 Fd Stamps 5372 W-140H FS Case Transferred to Following Center
    12 Fd Stamps 7909 W-140VV Food Stamp Recertification Notice F61 and F63
    12 Fd Stamps 7910 W-25M Residential Treatment Center Eligibility Recertification F61
    12 Fd Stamps 5392 W-515E New Eligibility Rules for Legal Aliens
    12 Fd Stamps 6400 W-515H Food Stamp Penalty Warning
    12 Fd Stamps 8046 W-532E Participant Request for Review of Employability Status
    12 Fd Stamps 8535 W-69-202 Self Address Return Envelope
    12 Fd Stamps 8804 W-901K Incomplete SNAP Application Form
    12 Fd Stamps 8228 W-908F Rescheduled Food Stamp Telephone Recertification Interview
    12 Fd Stamps 5414 Waiver of Authorized Representative
    12 Fd Stamps 7564 WINR0811 Newborn-Unborn FS Activation Report One page or one case only
    12 Fd Stamps 6172 WINRO153 Food Stamp Budget Calculation
    13 Medicaid 7366 1HHJ Job Ticket or Control Form CASA
    13 Medicaid 8529 2009 Archive CAH Service Pocket
    13 Medicaid 8532 2009 Archive OOT Service Pocket
    13 Medicaid 8530 2010 Archive CAH Service Pocket
    13 Medicaid 8533 2010 Archive OOT Service Pocket
    13 Medicaid 8531 2011 CAH Service Pocket
    13 Medicaid 7576 20CONTOASAS Restricted Recipient Activity Packet
    13 Medicaid 6868 423B Referral to Riverview Center
    13 Medicaid 7574 888 RRP Notice of Intent to Restrict Medicaid
    13 Medicaid 8158 Access NYC Online Renewal Summary
    13 Medicaid 5749 Acknowledgement of Fair Hearing Request
    13 Medicaid 5748 Action Taken on Application
    13 Medicaid 5743 ADC-U Screening Checklist
    13 Medicaid 8579 Additional Core DVE (16DI)
    13 Medicaid 8580 Additional IPE (16DC, 16PI)
    13 Medicaid 8582 Additional Supp DVE (16SI)
    13 Medicaid 8666 Affidavit Notice (any kind)
    13 Medicaid 6449 Affiliation Referral Form-3000 Series
    13 Medicaid 5825 Allowance Worksheet
    13 Medicaid 6450 ALPS Medicaid Information and Problem Check List
    13 Medicaid 5761 Applicant or Recipient Request for Conference Review
    13 Medicaid 5780 Application for Recertification for Information of Income and Resource
    13 Medicaid 5763 Application Review Checklist
    13 Medicaid 5808 Application Worker Daily Log
    13 Medicaid 8692 Approved Medicaid Prior Authorization ? Out of State SNF Placement
    13 Medicaid 6451 Assisted Living Program Assessment Review Form
    13 Medicaid 6452 Assisted Living Program Interim Assessment
    13 Medicaid 7940 Attestation for Medicaid Applications Rikers
    13 Medicaid 7957 Before Signing Up for Health Insurance Plan You Should Know
    13 Medicaid 8469 BFI-25C Report of Investigation (MA)
    13 Medicaid 8564 Cardiology Lab
    13 Medicaid 5830 Care Required by Sick or Disabled Household Member
    13 Medicaid 8339 CAS-200 Authorization for Health Information (Changed to current description on 3-26-13)
    13 Medicaid 5777 Case Record Request
    13 Medicaid 5764 Case Submission Sheet
    13 Medicaid 5845 Certification of Parental Failure to Cooperate in Protective Services
    13 Medicaid 6457 CHHA Conversion Alert Notice-3000 Series
    13 Medicaid 8406 Child/Teen Health Program Reply Form
    13 Medicaid 6424 Childhood Disability Evaluation Form Medicaid Program
    13 Medicaid 5620 Client Checklist for Medical Assistance
    13 Medicaid 6458 Client Task Sheet-Medical Review Team MRT Plan of Care-3000 Series
    13 Medicaid 6459 CMP Reviewer Letter
    13 Medicaid 6196 Community Eligibility Division-Data Entry Error Return Control
    13 Medicaid 5657 Community or Spouse Concerning Income be provided by Institutional
    13 Medicaid 8583 Comprehensive Service Plan Updated
    13 Medicaid 5623 Confidential Information Intended Solely For Professional Use Redisclosure Prohi
    13 Medicaid 5621 Confirmation of Identity for Medicaid Applicants
    13 Medicaid 5756 Consent for Bank Clearances
    13 Medicaid 7941 Consent to Release and Obtain Information for Health Care
    13 Medicaid 6460 Consumer Directed Personal Assistance Program Appl Info & Instructions
    13 Medicaid 5685 Consumer Guide to completing the Mail Recertification in Seven Steps
    13 Medicaid 5833 Continued Medicaid Coverage for Newborn Babies Recertification Statem
    13 Medicaid 8192 Credible Maintenance Statement
    13 Medicaid 5760 CRT Search
    13 Medicaid 5733 CS-19 Temporary Medicaid Authorization
    13 Medicaid 5706 CSC Job Referral Inquiry - Notice and Proof of Claim for Disability
    13 Medicaid 6461 Dear Doctor Letter
    13 Medicaid 5794 Decision of Medical Assistance Application
    13 Medicaid 5812 Decision on Applicant or Benefit for Medicare Buy-in Pgrm Notice of M
    13 Medicaid 6466 Decision to Auth Reauth Deny Discont. PERS PERS Emerg Respns Svc
    13 Medicaid 8565 Dermatology Lab
    13 Medicaid 7958 Determining Self Employment Income with Tax Returns for Medicaid-FEAU
    13 Medicaid 8786 DFTA Case Management Application form for MA Home Care
    13 Medicaid 6845 DFY 2507 Household Economic Impact-Confidential
    13 Medicaid 8526 Dialysis Notice (of any Kind)
    13 Medicaid 5855 Division of Hospital Eligibility - Notice of Medicaid Acceptance - MA
    13 Medicaid 7508 DOH Office of MA Management DATA MART RRP
    13 Medicaid 6626 DOH 4133 Growing Up Healthy
    13 Medicaid 6627 DOH 4133A Growing Up Healthy
    13 Medicaid 5535 DOH-1260 Local Medical Director Deter/Decision of Medical Eligibility
    13 Medicaid 5880 DOH-1565 Medical Insurance Determination
    13 Medicaid 7292 DOH-2557 NYS DOH Auth Release of Confidential HIV Related Info
    13 Medicaid 5636 DOH-3 Utilization Review
    13 Medicaid 7029 DOH-3608 HIV Uninsured Care Programs
    13 Medicaid 7163 DOH-3758 Missing information Letter Client to Return within 24 hrs
    13 Medicaid 7981 DOH-4097 Medicaid Managed Care and Family Health Plus Enrollment Form
    13 Medicaid 6746 DOH-4220 Health Insurance and Nutrition App For Medical Assistance
    13 Medicaid 7838 DOH-4282 Application for Family Plan Benefit Program
    13 Medicaid 7545 DOH-4325 Notice of Intent to Authorize/Reauthorize or Deny
    13 Medicaid 7476 DOH-4328 Medicare Savings Program Application
    13 Medicaid 8777 DOH-4337 Physician Confirmation Form
    13 Medicaid 8470 DOH-4419 Day Care Home Enrollment Form
    13 Medicaid 8190 DOH-4443 NYS-DOH Financial Maintenance
    13 Medicaid 8338 DOH-4469 Financial Status Form
    13 Medicaid 8256 DOH-4471 FHP Certification Treatment for Emergency Medical Condition
    13 Medicaid 8257 DOH-4495A Access NY Supplement A
    13 Medicaid 8167 DOH-4496 Medicare Savings Program Request for Information Form
    13 Medicaid 8170 DOH-4496 NYS Medicare Savings Program Request For Information
    13 Medicaid 8779 DOH-5027 PARR Mental Health Evaluation Report
    13 Medicaid 8784 DOH-51 Supplemental Report of Given Name
    13 Medicaid 5865 DOH-694 Hospital and Community-Patient Review Instrument
    13 Medicaid 6472 DOH-695-NYS Dept of Health Screen-Complete after reviewing PRI
    13 Medicaid 5917 DOH-799 WIC Medical Referral Form
    13 Medicaid 8788 DOHS Warrant for Arrest of Alien
    13 Medicaid 8497 Draft Supplement Needs Trust
    13 Medicaid 7880 DSP Medical Documentation
    13 Medicaid 7881 DSP Releases
    13 Medicaid 7879 DSP-DRD Medicaid Documents
    13 Medicaid 8010 DSP-DRD-0001 MA Application Package
    13 Medicaid 6402 DSS-1003 General Basic Medical Exam Record
    13 Medicaid 5806 DSS-1151 and DSS-1151-1 Instructions for Completing
    13 Medicaid 5444 DSS-1151 Disability Interview
    13 Medicaid 5651 DSS-1451 Disability Interview
    13 Medicaid 5491 DSS-1963EL Quality Control Results
    13 Medicaid 5449 DSS-2642 Documentation Requirements
    13 Medicaid 6160 DSS-2831A - MAP-2079K Temporary Medicaid Authorization
    13 Medicaid 5518 DSS-2831A Temporary Medicaid Authorization
    13 Medicaid 6404 DSS-3074 NYS Medical Assistance Program Status of Bed Reservation
    13 Medicaid 7206 DSS-3122 Medical Evaluation Resident Medical history
    13 Medicaid 5725 DSS-3133 Provider or Recipient Letter
    13 Medicaid 7165 DSS-3139 DOH Off of Hlth Systems Management - Home Assess Abstract
    13 Medicaid 5538 DSS-3183 Financial Obligation of Recip Toward Medical Expenses
    13 Medicaid 5655 DSS-3252 Verification of Legal Blindness
    13 Medicaid 7166 DSS-3394 Long Term Health Care Pro Waived Services Prior Author
    13 Medicaid 6405 DSS-3451 Comm for the Blind or Visually Handicapped Medical Eye Report
    13 Medicaid 5539 DSS-3477 Principal Provider Data Input Form
    13 Medicaid 5478 DSS-3517-15 Medical Assistance Coverage Data Entry Form
    13 Medicaid 5428 DSS-3570 Certification Guide
    13 Medicaid 5918 DSS-3576 WMS or NYC-MA Authorization Document
    13 Medicaid 5470 DSS-3585 MBL Budget Record Form
    13 Medicaid 7773 DSS-3602B APS ASSESSMENT OR SERVICES PLAN
    13 Medicaid 5735 DSS-3652 Transaction Cancellation Data Entry Form
    13 Medicaid 5869 DSS-3816 Individual Information Data Entry
    13 Medicaid 5482 DSS-3817 Mental Residual Functional Capacity Assessment
    13 Medicaid 5490 DSS-3818 Psychiatric Review Technique
    13 Medicaid 5724 DSS-3833 Prenatal Care Referral Form
    13 Medicaid 5887 DSS-3973 Notice of Decision on your Medicare Assist Application
    13 Medicaid 5473 DSS-41 Medicaid Presumptive Eligibility for Pregnant Women
    13 Medicaid 5664 DSS-4198 Third Party Data Sheet
    13 Medicaid 8475 DSS-4362 PPRI for Care At Home Waiver Program
    13 Medicaid 6483 DSS-4449-B Identifying Data Form from ALPS Provider
    13 Medicaid 6487 DSS-4449-C1 Medical Evaluation
    13 Medicaid 6453 DSS-4449-D1 Assisted Living Program Nurs/Functional/Social Assessment
    13 Medicaid 8799 DSS-445S ALP MA Recipient Absence Roster
    13 Medicaid 5712 DSS-4592 Medicare Premium Payment Program Application
    13 Medicaid 6406 DSS-466T Cardiovascular Medical Report
    13 Medicaid 5533 DSS-4834 Third Party Health Insur Data Medicare Coverage Update
    13 Medicaid 5480 DSS-486 Medical Report for Determination of Disability
    13 Medicaid 5481 DSS-486T Medical Report for Determination of Disability
    13 Medicaid 5672 DSS-515 Application for Medical Assistance and Addendum
    13 Medicaid 5854 DSS-5472 Complaint of Non-Compliance
    13 Medicaid 5446 DSS-639 Disability Review Team Certificate
    13 Medicaid 5729 DSS-746 Route Slip
    13 Medicaid 5668 DSS-901 Hospital Response to MAP 403A Request for Additional Info
    13 Medicaid 5805 Duplication of Data Verification in Determining MA Eligibility
    13 Medicaid 8816 EDITS Deferral Message
    13 Medicaid 8691 EIS Request Pocket
    13 Medicaid 5823 Eligibility Detail Inquiry
    13 Medicaid 6401 Eligibility for Medical Assistance City of NY
    13 Medicaid 5921 Eligibility Information
    13 Medicaid 8566 Endocrinology Lab
    13 Medicaid 8498 Executed Supplement Needs Trust
    13 Medicaid 5861 Explanation of the Effect of Transfers of Resources on Medical Eligib
    13 Medicaid 6475 Fair Hearing Compliance
    13 Medicaid 8778 Fair Hearing Division Evidence Packet Request
    13 Medicaid 8415 FHP Dis-enrollment form
    13 Medicaid 6477 Fiscal Assessment
    13 Medicaid 6478 Fiscal Assessment Control Form
    13 Medicaid 8418 G-639, Freedom of Information/Privacy Act Request
    13 Medicaid 8568 Gastroenterology Lab
    13 Medicaid 8576 General Surgery Lab
    13 Medicaid 8783 Good Cause Provider Transfer
    13 Medicaid 7903 HA 1151 Medical Statement To Do Work-Related Activities Physical
    13 Medicaid 7904 HA 1152 Medical Statement To Do Work-Related Activities Mental
    13 Medicaid 8205 HC - Service Section Packet
    13 Medicaid 7975 HC-Care at Home Back-File Packet
    13 Medicaid 7985 HC-Casa II Back-File Packet
    13 Medicaid 7986 HC-Casa III Back-File Packet
    13 Medicaid 7987 HC-Casa IV Back-File Packet
    13 Medicaid 7976 HC-Casa O Back-File Packet
    13 Medicaid 7988 HC-Casa V Back-File Packet
    13 Medicaid 7989 HC-Casa VI Back-File Packet
    13 Medicaid 7990 HC-Casa VII Back-File Packet
    13 Medicaid 7991 HC-Casa VIII Back-File Packet
    13 Medicaid 7992 HC-Casa X Back-File Packet
    13 Medicaid 8216 HC-Service Section Prior 2004 Archive
    13 Medicaid 7970 HCA-06 Request for Verification of Birth
    13 Medicaid 8346 HCBS Waiver Authorization
    13 Medicaid 8347 HCBS Waiver Termination
    13 Medicaid 7167 HCFA-485 Home Health Certification Plan of Care Dept HHS-HCFA
    13 Medicaid 7282 HCFA-566 - Medicare Managed Care Disenrollment Dept HSS-HCFA
    13 Medicaid 7214 HCFA-R-296 Home Health Advance Beneficiary Notice HHABN
    13 Medicaid 6476 HCSP 3000E Fair Hearing Compliance Notice
    13 Medicaid 6484 HCSP-3000 Notice of Initial Authorization of Home Care Cases
    13 Medicaid 6329 HCSP-3000A Home Care Services Program
    13 Medicaid 6462 HCSP-3000B Notice of Decision Not to Change Home Care Services
    13 Medicaid 6330 HCSP-3000C Notice of Denial of Home Care Services
    13 Medicaid 7113 HCSP-3000G Notice of Intent to Discontinue Home Care Services
    13 Medicaid 8037 HCSP-3000H Notice of Decision for Personal Emergency Response Services
    13 Medicaid 8035 HCSP-3000J Notice of Decision to Change Home Care Services Change
    13 Medicaid 8036 HCSP-3000L Notice of Decision to Change Home Care Services Technical
    13 Medicaid 8038 HCSP-3000M Notice of Decision to Change Home Care Services Other-Med
    13 Medicaid 6467 HCSP-3000T Notice of Decision to Change Home Care Services
    13 Medicaid 8126 HCSP-3000Y History Sheet
    13 Medicaid 7161 HCSP-3005A Decisn Notice Re Auth or Increase Task Based Service Plan
    13 Medicaid 8796 HCSP-3021 Case Submission Transmittal Enrollments
    13 Medicaid 8837 HCSP-3022 MLTC Medicaid Cover Sheet
    13 Medicaid 8781 HCSP-3026 ALP Medicaid Cover sheet
    13 Medicaid 8782 HCSP-3027 Notice of Determination for Acceptance to ALP
    13 Medicaid 5803 HCSP-709 Confirmation of Home Visit Request
    13 Medicaid 7114 HCSP-709A Request for Telephone Call
    13 Medicaid 7115 HCSP-L642 Long Term Home Care Prog Provider or CASA Transmittal
    13 Medicaid 5775 Health and Hospitals Corporation - Hospital Eligibility Division Pre-S
    13 Medicaid 8569 Hematology/Oncology Lab
    13 Medicaid 6583 HHC 045F1 HHC - Report
    13 Medicaid 5544 HHC-CD590 Hospital State of Patient Inability to Sign Citizenship
    13 Medicaid 5545 HHC-ES-590 Hospital Patient Inability to Sign Citizen Alien Declar
    13 Medicaid 8652 HIPAA Authorizations
    13 Medicaid 8653 HIPAA Request Packet
    13 Medicaid 5616 Hospital Bill For Excess Income and/or Resource Case
    13 Medicaid 6213 Hospital Computer printout of patient information
    13 Medicaid 5768 Hospital Eligibility Tracking System Referral Form
    13 Medicaid 5797 Hospital Request for Sex or Date of Birth Error Correction
    13 Medicaid 7164 HR-11 Notice Admit to Congregate Care Rebudget SNA Grant Transfer
    13 Medicaid 6214 HRA Info line NPA Medicaid Tracer
    13 Medicaid 7947 HRA W-333C Activities of Daily Living
    13 Medicaid 7948 HRA W-333D Physician Assessment Form
    13 Medicaid 7949 HRA W-333E Travel Capacity Assessment - Reviewer Outcome Form
    13 Medicaid 7950 HRA W-333F Medical Release of Information
    13 Medicaid 7370 HRA/DIV of Accts Receivable, Receipt for Payments (MAP Pay-in Prog.)
    13 Medicaid 7414 Hurricane Katrina Evacuee -DASC Universal Intake Form MISCA
    13 Medicaid 8780 I-220A DOHS Immigration and Customs Enforcement
    13 Medicaid 5868 Important Notice of Decision on your MA Application Community Covera
    13 Medicaid 5637 Important Notice to Parents of Children with Income MAP-2087E
    13 Medicaid 5787 Information about special medical exam needed for continuation of Me
    13 Medicaid 5746 Information Concerning Medical Assistance for SSI Beneficiaries
    13 Medicaid 5702 Inpatient New York City Health and Hospital Corp CRT Clearance Form
    13 Medicaid 5774 Institutional Care or Nursing Homes Request for Information
    13 Medicaid 8509 IREA C&C MA Income
    13 Medicaid 7515 Katrina-02 E-S Notice: Discontinuance Of Disaster Relief MA Cover
    13 Medicaid 7516 Katrina-03 E-S Notice Of Renewal Of Medical Assistance Coverage
    13 Medicaid 7946 LDSS-1151 Disability Interview
    13 Medicaid 8681 LDSS-2031A Temporary Medicaid Authorization
    13 Medicaid 5857 LDSS-2642P Documentation Checklist for Pregnant Teens/Young Children
    13 Medicaid 8832 LDSS-4146 Notice of Your Decision on MA Application
    13 Medicaid 8797 LDSS-4623A Adoption Subsidy/Non-Recurring Adoption Expenses Agreement
    13 Medicaid 8835 LDSS-4687 Managed Care Action Taken
    13 Medicaid 7945 LDSS-486T Medical Report for Determination of Disability
    13 Medicaid 8817 LDSS-4882 Application/Referral for Child Support Services
    13 Medicaid 5762 Letter to Past or Present Employer
    13 Medicaid 5546 LO-406S Benefits Paid-Copy of Check-Statement of
    13 Medicaid 6486 Local Medical Director Review Form
    13 Medicaid 5804 Long Term Care Division Clearance Form
    13 Medicaid 6219 Longterm Care Facility Rpt MA Recipient Adms/Readmi or Disch DSS
    13 Medicaid 8776 LTHHC Respiratory Therapy Evaluation
    13 Medicaid 8328 LTHHCP4323 Intent to Discontinue Your Participation
    13 Medicaid 8329 LTHHCP4325 Authorize/Reauthorize or Deny Your participation
    13 Medicaid 8330 LTHHCP4327 Reduce Your SNF Level Budget to HRF Level Budget
    13 Medicaid 8331 LTHHCP4339 Notice of Intent to Reduce/Discontinue Services
    13 Medicaid 8332 LTHHCP4341 Notice of Intent to Deny Services
    13 Medicaid 6494 M-11a or M-11V OHCS/MAP Transmittal with to Computer Operations
    13 Medicaid 6333 M-11c Home Care Field Questionnaire
    13 Medicaid 6334 M-11d Home Care Reauthorization Assessment
    13 Medicaid 5492 M-11G Reauth-Recert Statement for Home Care Clients
    13 Medicaid 6485 M-11q Letter mailed to Client with
    13 Medicaid 6335 M-11s Home Care Social Assessment
    13 Medicaid 5864 M-11v Home Care Services Program Stop Service Auth or Adjust Billin
    13 Medicaid 6456 M-13d CDPAP Application
    13 Medicaid 6491 M-13v Notice of Decision on CDPAP Application
    13 Medicaid 6501 M-14p Special HA or HHA Request & Authorization
    13 Medicaid 6493 M-27r Addendum Nursing Assessment Follow-up
    13 Medicaid 6339 M-27R Nurse's Assessment Visit Report
    13 Medicaid 7023 M-27t Nurse's Supervisory Visit Report
    13 Medicaid 5694 M-28A Home Care Reviewers Decision
    13 Medicaid 6496 M-28q Personal Emergency Response Services Evaluation Form
    13 Medicaid 7162 M-28x Pending Team Telephone Assessment Document HCSP-4 pages
    13 Medicaid 5883 M-322R Newborn Child Accepted for Medicaid Coverage
    13 Medicaid 5717 M-3T Notice of Ineligibility of Application for Medical Assistance
    13 Medicaid 6943 M-42q Certification For Retroactive Medicaid Coverage
    13 Medicaid 6867 M-42v Medicaid Choice or Managed Care Referral
    13 Medicaid 6473 M-485 Doctor's Order or Plan of Care
    13 Medicaid 1716 M-76j Consent for Disclosure of MAP Records of ASA Treatment
    13 Medicaid 8114 M-858G Notice of Refund of Home Energy Allowance Deduction
    13 Medicaid 8088 M11Q-Medical Request for Home Care Services
    13 Medicaid 8798 MA Model Waivers CAH I & II Program
    13 Medicaid 8287 MA Only Package HASA
    13 Medicaid 5923 Mail In Recertification Statement
    13 Medicaid 5779 Mail Recertification Program Referral Letter
    13 Medicaid 7797 Manual Notice of Transition of MA-FHP County A
    13 Medicaid 5689 MAP /E C257 Eligibility/Recertification for Medicaid, Notice of
    13 Medicaid 6421 MAP /E C795 Recertification Statement
    13 Medicaid 6356 MAP /E E11 Transmittal to Statistical Section of Educational AID Cases
    13 Medicaid 6311 MAP /E H403A Request for Additional Information
    13 Medicaid 6246 MAP 1016C Request for Public Transportation Reimbursement
    13 Medicaid 5843 MAP 2004W Batch Transmittal
    13 Medicaid 6342 MAP 2008 Third Party Health Insurance TPHI Report for PWA Application
    13 Medicaid 5661 MAP 2016 Prescreening Referral
    13 Medicaid 5487 MAP 2025W Over the Counter Case Documentation Checklist
    13 Medicaid 6826 MAP 2033K Fair Hearing Notice Acceptance FHP Application
    13 Medicaid 5489 MAP 2033M Pre Fair Hearing Summary
    13 Medicaid 5691 MAP 2033N Fair Hearing Decision Notice
    13 Medicaid 5635 MAP 2050E Medical Assistance Program Benefits Checklist
    13 Medicaid 6412 MAP 2052M Request for Approval of Taxi or Car Service Fare
    13 Medicaid 5514 MAP 2069A Structured Surplus Income Program History Sheet
    13 Medicaid 5644 MAP 2070W Institutionalized Budget Assessment Worksheet
    13 Medicaid 5720 MAP 2083A Out of Pocket Reimbursement List
    13 Medicaid 6499 MAP 2091N Return Form CASA Medical Review Team, Sent to Service Team
    13 Medicaid 5911 MAP 2092B Temporary Absence Unit Case Control
    13 Medicaid 5727 MAP 2094A Recertification Statement for Home Care Clients
    13 Medicaid 5690 MAP 2100D MAP 201 Employment History of
    13 Medicaid 6407 MAP 2116M Request for Simplified Asset Review for Medicaid Eligibility
    13 Medicaid 5904 MAP 2124A Selective Supervisory Review Completed Case Log
    13 Medicaid 6306 MAP 2162T Which Application Form Do I Need Reverse in Spanish
    13 Medicaid 5699 MAP 2172D Important Notice About Medicaid Reimbursement
    13 Medicaid 6309 MAP 861 State Quality Control Case Requiring Corrective Action
    13 Medicaid 5660 MAP 931 Explanation of the Excess Income Program
    13 Medicaid 5462 MAP Certification Guide for Medical Assistance Community Care Cases
    13 Medicaid 5836 MAP Dear Medicaid Recipient in order to complete recertification
    13 Medicaid 5687 MAP Discharge to Foster Care Placement Special Services for Children
    13 Medicaid 5924 MAP Division of Hospital Eligibility or Notice of Medicaid Acceptance
    13 Medicaid 5465 MAP E201 Letter to Past Present Employer
    13 Medicaid 6930 MAP Facilitated Enroller Client Information (any kind)
    13 Medicaid 5464 MAP Letter to Past or Present Emp Requesting Health Insurance Benefits
    13 Medicaid 5926 MAP Medicaid Transportation Prior Approval of Non emergency Ambulance
    13 Medicaid 8702 MAP MLTC Medicaid Application Checklist
    13 Medicaid 5675 MAP QPA-0488 Application/Reconsideration Transmittal and Receipt
    13 Medicaid 5505 MAP Request for Documentation Info for Recert Community Elig Division
    13 Medicaid 5648 MAP- 2087 DIS Discontinue Medical Assistance-Notice of Intent to
    13 Medicaid 7059 MAP-0911D Notice of update on your Disaster Relief Medicaid
    13 Medicaid 6836 MAP-0911N Notice of Denial of Medicaid (FHP/DR)
    13 Medicaid 7056 MAP-0911T Failure to Appear at Face to Face Interview (DRM)
    13 Medicaid 7050 MAP-101 MBI-WPD Prescreening Document (Buy-In Program)
    13 Medicaid 7058 MAP-1016F Change of Address form
    13 Medicaid 6197 MAP-1016H0 Complaint Resolution Form
    13 Medicaid 7836 MAP-101B Acknowledgment for Application (for public health)
    13 Medicaid 8399 MAP-101F Photograph Referral-CBIC Card
    13 Medicaid 6674 MAP-1049f Child Health Plus A or B Separate Determination Referral
    13 Medicaid 7335 MAP-1058B(E-S) Notice of Intent to Discontinue your MA Restriction
    13 Medicaid 5547 MAP-1094B Child Health Plus Information
    13 Medicaid 6843 MAP-1094F Child Hlth. Plus A/B Separate Determination Referral
    13 Medicaid 7839 MAP-1096 Child/Teen Health Plan Fact Sheet
    13 Medicaid 6805 MAP-1096K 06/07/02 Child/Teen Health Program Client Affirmation
    13 Medicaid 7336 MAP-1096M (E-S) C/THP Reply Form
    13 Medicaid 5447 MAP-1122 Discharge Alert
    13 Medicaid 5771 MAP-1123 Change or Cancellation in Discharge Plan MAP-259E replaces
    13 Medicaid 5488 MAP-1124 Planned Discharge Notice MAP-259F replaces
    13 Medicaid 5641 MAP-1389 Fair Hearing Compliance Follow-up Notice
    13 Medicaid 6409 MAP-1755 Medicare Online System-Benefits Status
    13 Medicaid 7062 MAP-2001C Notice of Continuation of MA Elig. after Recertification
    13 Medicaid 5863 MAP-2002 Formerly MAP/E 1127-Discharge Unit Planning Log
    13 Medicaid 5515 MAP-2003B Supplemental PICKLE Amendment Questions
    13 Medicaid 5520 MAP-2003H Veterans Benefits Questionnaire
    13 Medicaid 5501 MAP-2007 Referral to Disability Review Division
    13 Medicaid 5549 MAP-2008H Veterans Benefits Questionnaire
    13 Medicaid 7323 MAP-2009A Restricted Recipient Program - Notice to Doctor
    13 Medicaid 5931 MAP-2010D Notice of Denial of Your nursing Home Application
    13 Medicaid 5550 MAP-2016A Application Control Card-Copy 3
    13 Medicaid 6844 MAP-2016H Notice of Deferral - Access NY Health Care
    13 Medicaid 5506 MAP-2016H Request for Documentation Information
    13 Medicaid 5632 MAP-2016M Prescreening Interview Checklist
    13 Medicaid 5461 MAP-2016P Interview Guide History Sheet
    13 Medicaid 5420 MAP-2016R Application Control Card
    13 Medicaid 7337 MAP-202 (E-S) Homebound Food Stamp Application Cover Letter
    13 Medicaid 8255 MAP-2020X FHP-Premium Assistance Program Outreach Notice - Acceptance
    13 Medicaid 8524 MAP-2020Y Family Health Plus-Premium Assistance Program
    13 Medicaid 6410 MAP-2025C CED Manual Recertification Log
    13 Medicaid 8704 MAP-2025D Request For Documentation/Information For Recertification
    13 Medicaid 7116 MAP-2025G Recertification Request for Resource & Income Verification
    13 Medicaid 5878 MAP-2025H Notice of Assistance From Facilitated Enrollers
    13 Medicaid 6886 MAP-2025J Pre-Screening Doc. Checklist and Reg. Case Type(s) Assign.
    13 Medicaid 5450 MAP-2025S Earned Income and Health Insurance Questionnaire
    13 Medicaid 5494 MAP-2025Z Recert Request for Resources and Income Information
    13 Medicaid 5932 MAP-2026 Form SS-5 Transmittal Letter
    13 Medicaid 5551 MAP-2026A Confirmation of Identity-Request for
    13 Medicaid 5552 MAP-2026C Bank Account Information-Request for
    13 Medicaid 5553 MAP-2026H Confirmation of Identity-Request for
    13 Medicaid 7229 MAP-2026J Attestation of Effort To Apply For SS Number (For Medical Assistance)
    13 Medicaid 7824 MAP-2026K Request For Certification of Birth NYC
    13 Medicaid 7825 MAP-2026M Request For Certification of Birth
    13 Medicaid 8028 MAP-2026U Request for Social Security Number State Benefits
    13 Medicaid 5736 MAP-2027 Transmittal for Division for Youth Cases
    13 Medicaid 7117 MAP-2028A Social Security Number Verification
    13 Medicaid 6837 MAP-2028J Instruction for Mailing Health Ins. Premium
    13 Medicaid 7338 MAP-202A (E-S) Homebound Food Stamp Application Questionnaire
    13 Medicaid 7052 MAP-2030 Notice Regarding Residency
    13 Medicaid 7053 MAP-2030A County Commissioner Letter
    13 Medicaid 7209 MAP-2030C Notice Regarding Residency
    13 Medicaid 7320 MAP-2030D Residence/Mailing Address Inquiry
    13 Medicaid 6892 MAP-2031B Consent to Release Information
    13 Medicaid 6838 MAP-2033B Fair Hearing Notice of Denial of MA/FHP
    13 Medicaid 6839 MAP-2033C Fair Hearing Plan Selection Notice
    13 Medicaid 5692 MAP-2033H Fair Hearing History Sheet
    13 Medicaid 6628 MAP-2033P Fair Hearing Summary
    13 Medicaid 6825 MAP-2033R-Fair Hearing Compliance Follow-up Notice
    13 Medicaid 5782 MAP-2043F Request For Resource Information Lawsuit Settlement
    13 Medicaid 7118 MAP-2043K Referral to Office of Revenue and Investigation
    13 Medicaid 5900 MAP-2043Y Referral Concerning Real Property of Institutional Individ
    13 Medicaid 7900 MAP-2050 Client Statement of Monthly Expenses
    13 Medicaid 5431 MAP-2050 Client Statement of Monthly Expenses
    13 Medicaid 5700 MAP-2050 Important Notice for Medicaid Recipients/Medical Assistance
    13 Medicaid 5440 MAP-2050A Declaration of Income or Support For Medical Assistance
    13 Medicaid 7896 MAP-2050A Declaration of Income Support
    13 Medicaid 5439 MAP-2050B Declaration of Support Mail Recertification
    13 Medicaid 7339 MAP-2050G Resource Verification/Attestation (For Medical Assistance)
    13 Medicaid 7394 MAP-2050H Processing FHP Cases With Resources Over Resource Limit
    13 Medicaid 8129 MAP-2050J Equity Statement House or Condominium or Co-Op Apartment
    13 Medicaid 5443 MAP-2052A Disability Determination Worksheet
    13 Medicaid 5696 MAP-2052B How to Obtain Medicaid in the Aid to the Disabled Category
    13 Medicaid 5504 MAP-2052C Request for Additional Medical Information
    13 Medicaid 7793 MAP-2052G Information About Special Medical Exam
    13 Medicaid 7754 MAP-2052H Notice of Equipment for CE
    13 Medicaid 5841 MAP-2052K Authorization to Release Consultative Examination Report
    13 Medicaid 6413 MAP-2052N Authoriz for Taxi Car Service for Consultive Examination
    13 Medicaid 5688 MAP-2052R DRS Consultive Examination or test order form
    13 Medicaid 8663 MAP-2055n Medicaid FHPlus and Kids Insurance
    13 Medicaid 5426 MAP-2060 Budget Explanation
    13 Medicaid 5844 MAP-2060A Catastrophic Budget Explanation
    13 Medicaid 5454 MAP-2060B Expensive Hospital Care Budget Explanation
    13 Medicaid 5425 MAP-2060C Budget Explanation-Institutional Services
    13 Medicaid 7340 MAP-2060D Budget Explan. Institut. Serv. Adj NAMI Based On Med Bills
    13 Medicaid 6923 MAP-2060E Zero NAMI Request - Viable Bills worksheet
    13 Medicaid 6878 MAP-2060G Request Payment for NH Services Retroactive Two Yrs or More
    13 Medicaid 6872 MAP-2060J Budget Explanation - Nursing Home Eligibility Division
    13 Medicaid 6879 MAP-2061B Consent to Release Information
    13 Medicaid 5516 MAP-2069B Surplus Income Ledger Replaced by MAP-802V
    13 Medicaid 6835 MAP-2069F Denial of your Disaster Relief Medicaid/FH Plus, Notice of
    13 Medicaid 5667 MAP-2069K Surplus Income-Notice of
    13 Medicaid 6536 MAP-2069N Medical Expenses Paid or Incurred By a Public Program
    13 Medicaid 5650 MAP-2070A Spouse-Notice to-New Case
    13 Medicaid 7341 MAP-2070B Notice To Spouse (Undercare)
    13 Medicaid 5642 MAP-2070G Notification of Permanent Absence Status or Status Change
    13 Medicaid 5649 MAP-2070N Estab a Liability toward Chronic Care-Notice of Intent to
    13 Medicaid 7342 MAP-2070P Notice Of Assessment
    13 Medicaid 5718 MAP-2070U Notice to Spouse Concerning Income Institutional Spouse
    13 Medicaid 8130 MAP-2070W Institutionalized Spouse Budget Worksheet
    13 Medicaid 7343 MAP-2070X Community Spouse Monthly Income Allowance Refusal Statemnt
    13 Medicaid 5653 MAP-2074 Medicaid Authorization-Statement of
    13 Medicaid 6927 MAP-2075F Substance Abuse Case Control Referral
    13 Medicaid 5723 MAP-2078A Payment Request Form
    13 Medicaid 5840 MAP-2079A Approval Form for Temporary Medicaid Authorization
    13 Medicaid 6877 MAP-2080J Budget Explanation - NHED non spousal cases
    13 Medicaid 5554 MAP-2081 Documentation Information Tape-Request for
    13 Medicaid 5424 MAP-2081A Authorization to Release Information
    13 Medicaid 5721 MAP-2083E Paid Medical Bills Reimbursement Notice
    13 Medicaid 6785 MAP-2083H Medical Assistance/Home Care Reimbursement Detail Form
    13 Medicaid 7082 MAP-2083P Provider Enrollment Letter
    13 Medicaid 5734 MAP-2086 Conference and Fair Hearing Information
    13 Medicaid 7344 MAP-2086A (E-S) Right To A Conference
    13 Medicaid 7218 MAP-2086B Conference And Fair Hearing Information
    13 Medicaid 8397 MAP-2087a Denial of Your Application for Public Health Insurance
    13 Medicaid 5555 MAP-2087B Change Medical Assistance-Notice of Intent to
    13 Medicaid 8493 MAP-2087c Notice of Intent to Discontinue Medical Assistance (OMR-MISC
    13 Medicaid 5556 MAP-2087c Notice of Intent to Discontinue Medical Assistance (Stenson)
    13 Medicaid 8512 MAP-2087c Notice to Discontinue P-H-I Coverage/Person is deceased
    13 Medicaid 7119 MAP-2087V Decision Notice: on Elig. for MA Buy-In(AC MA-Only Recip.)
    13 Medicaid 7345 MAP-2088 Decision Notice On Your MA Application (Transfer of Assets)
    13 Medicaid 7157 MAP-2088B Decision Notice: MA Appl. Nursing Home Serv. was MEP-2088B
    13 Medicaid 7346 MAP-2088C Notice Of Intent To Change Medicaid Coverage
    13 Medicaid 7158 MAP-2088E Acceptance Notice, Limited Coverage MA Appl (Surplus Inc.)
    13 Medicaid 5663 MAP-2088H Notice of Acceptance of Your MA Application Pregnancy
    13 Medicaid 5557 MAP-2088I Acceptance of your Medicaid Application Notice of
    13 Medicaid 7892 MAP-2088N Notice of Action for Payment of Cobra Coverage
    13 Medicaid 7396 MAP-2088V Notice Of Continuation Of Your MA After Renewal
    13 Medicaid 7347 MAP-2089A Notice of Change in Your Net Available Monthly Income (NAMI)
    13 Medicaid 8494 MAP-2089c Continuing Medicaid Coverage Children Under 19 Years of Age
    13 Medicaid 7348 MAP-2089Q Notice To Discontinue Your Full MA Coverage (Code 07)
    13 Medicaid 6103 MAP-2090A Notification of Quality Control Finding
    13 Medicaid 5839 MAP-2091P Acknowledgement Letter
    13 Medicaid 7160 MAP-2091Q MES/Service Team Medicaid Applicant Info. Exchange (CASA)
    13 Medicaid 5683 MAP-2091W Community Alternative Systems Agency
    13 Medicaid 5559 MAP-2094L Recertification Statement MRP
    13 Medicaid 5500 MAP-2094L Recertification Statement MRP Formerly MEP-2094L
    13 Medicaid 6842 MAP-2094P Stenson History Sheet
    13 Medicaid 6043 MAP-2094Z Important Information about Medicaid Cards
    13 Medicaid 6414 MAP-2096 Instruct for Preg Teenagers and First-Time Mothers Accepted
    13 Medicaid 7057 MAP-2096B Growing up Healthy Recert Persons Under age 19
    13 Medicaid 7599 MAP-2096F/2096G Renewal Original/Reminder Form
    13 Medicaid 6821 MAP-2096J - Terms Rights And Responsibilities
    13 Medicaid 6834 MAP-2096M Medicaid/Family health Plus - Recert Reminder Notice
    13 Medicaid 6810 MAP-2096N Notice Regarding Your Medical Assistance-Mail Renewal E-S
    13 Medicaid 8795 MAP-2096q Renewal Instructions
    13 Medicaid 8128 MAP-2096V No Longer Eligible for Medicaid on Parents Case
    13 Medicaid 6763 MAP-2097 Client Affirmation Application Checklist
    13 Medicaid 6764 MAP-2097A Program Selection or Pregnancy
    13 Medicaid 8365 MAP-2097c Notice of Change from Full MA to Family Health Plus
    13 Medicaid 6822 MAP-2097J-Notice of FHP Acceptance of Your Health Insurance Appl
    13 Medicaid 6773 MAP-2097K Health Insurance Eligibility Screening Worksheet
    13 Medicaid 6887 MAP-2097TNotice of Change From MA to FHP (Mail Renewal)
    13 Medicaid 6779 MAP-2097V Information About Parents/Spouses Not Living in Household
    13 Medicaid 6840 MAP-2097W Notice of Denial of Hlth Ins Appl F.E./Excess Inc/Resources
    13 Medicaid 8417 MAP-2097Y Important Notice of Change from FHP to MA
    13 Medicaid 5519 MAP-20Transmittal for PSA for Adults Medicaid Eligibility
    13 Medicaid 5684 MAP-2100A Conference Unit Resolution Control
    13 Medicaid 5676 MAP-2100B Appointment for Conference
    13 Medicaid 6353 MAP-2105 Request for Amend to a Petition to Appoint a Conserv Commit
    13 Medicaid 5561 MAP-2105H Request for Bank Account Information
    13 Medicaid 5562 MAP-2105N Request for Account Information
    13 Medicaid 8127 MAP-2105Y Request to Amend a Petition to Appoint a Guardian
    13 Medicaid 5476 MAP-2109A Medicaid Resource History
    13 Medicaid 7051 MAP-2116K Hospital Request for MA Coverage for ALOC Days
    13 Medicaid 5509 MAP-2116M Request for Simplified Asset Review for Medicaid Eligibility
    13 Medicaid 6416 MAP-2120G Medicaid Recertification Documentation for Home Care Cases
    13 Medicaid 5565 MAP-2121H Home Visit Request
    13 Medicaid 5512 MAP-2123 Statement in Support of Claim Veterans Administration 21-4138
    13 Medicaid 6504 MAP-2131 Agreement Relative Friend Participate in Home Care Services
    13 Medicaid 5853 MAP-2134A Community Senior Service Network Project Transmittal Form
    13 Medicaid 5566 MAP-2135 Burial Fund Acknowledgement
    13 Medicaid 6216 MAP-2136 Institutional Services Certification Guide
    13 Medicaid 5463 MAP-2136A Interview Certif Guide for MA Hospital In-Patient Cases
    13 Medicaid 5453 MAP-2137 Expedited Application Tracking Form Central HED
    13 Medicaid 5513 MAP-2150 Statement of Medical Condition
    13 Medicaid 5471 MAP-2150A MCU Physician Review Form
    13 Medicaid 5429 MAP-2151 Certification of Treatment of Emergency Medical Condition
    13 Medicaid 6417 MAP-2151A Letter to Attending Physician
    13 Medicaid 5568 MAP-2151C Alien Desk Aid
    13 Medicaid 5569 MAP-2151D Notice of Resettlement Agency
    13 Medicaid 7350 MAP-2151K Decision Notice To Close Your Emergency MA Coverage Case
    13 Medicaid 7055 MAP-2153A Hospital Request for Medicaid Claim Number
    13 Medicaid 5570 MAP-2158 Medicare Buy- In Program Eligibility Review
    13 Medicaid 5596 MAP-2158B Medicare Buy-In Program Eligibility Review
    13 Medicaid 5572 MAP-2158C Buy Medicare Buy-In Addition Transmittal
    13 Medicaid 7159 MAP-2158E Client Request to be Removed From The Medicare Buy-In
    13 Medicaid 6944 MAP-2158F Medicare Buy-In Deletion Transmittal
    13 Medicaid 5573 MAP-2158H Health Insurance Transmittal
    13 Medicaid 5784 MAP-2158P Request For Part A - Medicare Savings Program
    13 Medicaid 5719 MAP-2159 Notification of Change or Correction to file from nursing
    13 Medicaid 5597 MAP-2159A Medicaid Questionnaire for RHCF Residents
    13 Medicaid 5934 MAP-2159B Nursing Home Eligibility Division ORI Tracking Report
    13 Medicaid 5933 MAP-2159C Transmittal for Nursing Facility Medicaid Applications
    13 Medicaid 8627 MAP-2159G Notice of Return of Unprocessed Nursing Home Case
    13 Medicaid 5703 MAP-2159H Institut Care or Nursing Home Info Req MAP-216B Replaces
    13 Medicaid 7293 MAP-2159K MA Nursing Home Excess Remittance Report ONE client only
    13 Medicaid 5846 MAP-2159Q Certification of Receipt of German Reparation
    13 Medicaid 6876 MAP-2159W RHCF - Disenrollment Request
    13 Medicaid 7397 MAP-216 Request for Documentation (Mail Renewal)
    13 Medicaid 5576 MAP-2160 Transfer of Assets Worksheet
    13 Medicaid 5437 MAP-2161 Declaration of Applicant Recipient
    13 Medicaid 5441 MAP-2161A Declaration of the Legally Responsible Relative
    13 Medicaid 5448 MAP-2162E Documentation Certification Checklist
    13 Medicaid 5475 MAP-2162H Continued Medicaid Coverage for Newborn Babies
    13 Medicaid 5633 MAP-2162H Continued Medicaid for Newborn Babies
    13 Medicaid 5662 MAP-2162N Certification Program Prenatal Care Assistance Program
    13 Medicaid 5577 MAP-2162Q Request for Documentation Medicaid WIC
    13 Medicaid 6354 MAP-2163 NY NY Connect Progr Enroll Request MAP Clearance and Decision
    13 Medicaid 7322 MAP-2166B Comprehensive MA Case Management (CMCM) Provider Xfer Req.
    13 Medicaid 7351 MAP-216B Institutional Care/Nursing Homes Request For Information
    13 Medicaid 8394 MAP-216D Request for Documentation-Quality Control Unit
    13 Medicaid 5634 MAP-217 BEV Appointment Letter
    13 Medicaid 5578 MAP-2174C BEV Appointment Notice
    13 Medicaid 5469 MAP-2174D MAP Referral to BEV
    13 Medicaid 5579 MAP-2175 Notification to Clients about Alcoholism & SA Req. for MA
    13 Medicaid 5631 MAP-2175A Medical Assistance Program Referral to SACC
    13 Medicaid 5800 MAP-2175B Disclosure Consent Alcohol or Drug Abuse Treat Prgrms Rcrds
    13 Medicaid 6880 MAP-2175D Dept Health & Mental Hygiene(DMH) Prescreening(BRADH unit)
    13 Medicaid 5507 MAP-221 Request for Information on Income Producing Property
    13 Medicaid 7352 MAP-227 Notice: MA Authorization For Division For Youth (DFY) Cases
    13 Medicaid 8665 MAP-228D Facilitated Enroller Selection Letter
    13 Medicaid 6743 MAP-25 MAP-2014 Medicaid Separate Determination History Sheet
    13 Medicaid 8409 MAP-252A Request to Complete Form DSS-486T
    13 Medicaid 7398 MAP-252E Disability Review Referral (CHP A)
    13 Medicaid 7951 MAP-252F Aids or Aids Related Complex Medical Report
    13 Medicaid 6866 MAP-252F AIDS or AIDS Related Complex Medical Report
    13 Medicaid 7487 MAP-252G Notice Of Disability Determination (CHP A Eligibility)
    13 Medicaid 6897 MAP-255 Language Questionnaire
    13 Medicaid 6418 MAP-2559 Health Insurance Questionnaire
    13 Medicaid 7321 MAP-255C MA - Managed Long Term Care Language Read Questionnaire
    13 Medicaid 7972 MAP-258A Notice of Change to Your Medicare Savings Program Coverage
    13 Medicaid 7381 MAP-258D Notice Concerning Eligibility for the Medicare Savings Program
    13 Medicaid 7526 MAP-258E Client Request: Remove from MA Svngs Prgrm (rplc MAP-2158E)
    13 Medicaid 7488 MAP-258F Notice To Medicare BuyIn Applicant With Excess Income (OED)
    13 Medicaid 8401 MAP-258g Notice to Consumer Regarding Medicare Savings-Post Budget-OED
    13 Medicaid 7353 MAP-258K Decision Notice: Application/ReEnrollment to MA Savings Pgm
    13 Medicaid 5711 MAP-258M Medicare Buy-In Program Eligibility Review
    13 Medicaid 8605 MAP-258n Notice of Change to Your Medicare Savings Program (MSP)
    13 Medicaid 8603 MAP-258t Medicare Savings Program Outreach Notice
    13 Medicaid 7899 MAP-258V Medicare Savings Program Deferral Notice (OED)
    13 Medicaid 7898 MAP-258X Medicare Savings Program Deferral Notice (C-REP)
    13 Medicaid 7354 MAP-259 Auth. For Short-Term Rehabilitative Nursing Home Care (RVI)
    13 Medicaid 7355 MAP-259A Notice MA Recert. Elig. Decision (Institut. /Nursing Homes)
    13 Medicaid 7207 MAP-259B Notice Of Denial Of Your Nursing Home Application
    13 Medicaid 8521 MAP-259c Medicaid Coverage Start Date
    13 Medicaid 7493 MAP-259C Revision of "Pick Up" Date (Nursing Homes)
    13 Medicaid 8145 MAP-259D Discharge Alert
    13 Medicaid 7382 MAP-259E Change / Cancellation in Discharge Plan (Replaces MAP-1123)
    13 Medicaid 7383 MAP-259F Discharge Notice (Replaces MAP-1124)
    13 Medicaid 7384 MAP-259G Respite Stay
    13 Medicaid 8029 MAP-259H Consumer Intent to Return / Not to Return Home
    13 Medicaid 5925 MAP-259N Conversion of Former Nursing Facility Case
    13 Medicaid 7513 MAP-259P Notice of Acceptance Of Your MA Application (HCSP-MLTC)
    13 Medicaid 8697 MAP-259q Notice of Spouse
    13 Medicaid 5640 Map-259T Conversion of Active PA or SSI case to Nursing Facility Care
    13 Medicaid 8523 MAP-259t Request to Convert Case
    13 Medicaid 8608 MAP-259v Notice of Decision on Your Medical Assistance for LTC Service
    13 Medicaid 8137 MAP-259W Contribution Toward Chronic Care Costs
    13 Medicaid 8706 MAP-259X Notice of Decision On Your Medical Assistance Application
    13 Medicaid 7837 MAP-259Y Notice of Decision on your request for Undue Hardship
    13 Medicaid 8382 MAP-259Z Claim of Undue Hardship
    13 Medicaid 7054 MAP-25A History Sheet (For LDSS-2921 and DOH-4220)
    13 Medicaid 7083 MAP-25B History Sheet
    13 Medicaid 8023 MAP-25D MSD History Sheet ll
    13 Medicaid 7833 MAP-25E History Sheet - Surplus Income / Pay-In Program
    13 Medicaid 8031 MAP-25G History Sheet (Nursing Home Eligibility Division
    13 Medicaid 8024 MAP-25H Stenson ll History Sheet
    13 Medicaid 8030 MAP-25J History Sheet (Medicaid Managed Care)
    13 Medicaid 8479 MAP-25n History Sheet (Quality Control)
    13 Medicaid 8380 MAP-25p Eligibility Information Services
    13 Medicaid 5599 MAP-2985 Notification to Hospital of Medicaid Decision
    13 Medicaid 8370 MAP-3002 Surplus Income Program Decision Notice Coverage Authorized
    13 Medicaid 8369 MAP-3002a Surplus Income Program Decision Coverage Not Authorized
    13 Medicaid 8367 MAP-3002c Managed Care Guarantee Explanation and Consumer?s Selection
    13 Medicaid 8395 MAP-3002e Notice of Change from Full MA to Surplus Income Program-MSP
    13 Medicaid 8851 MAP-3002g Managed Care Options and Consumer?s Selection
    13 Medicaid 8315 MAP-3003 Request to Provide Additional Documentation
    13 Medicaid 8372 MAP-3004 Bridges to Health (B2H) Application Transmittal
    13 Medicaid 8373 MAP-3004a Bridges to Health (B2H) Renewal Transmittal
    13 Medicaid 8646 MAP-3005 Notice of Restricted Access to MAP Locations
    13 Medicaid 8366 MAP-3006a Response to Request for Removal of Health Insurance
    13 Medicaid 8384 MAP-3009 Request for Information Supplemental Needs Trusts
    13 Medicaid 8416 MAP-3010 Request for Additional Information
    13 Medicaid 8383 MAP-3011 Medical Assistance Program Referral and Tracking Form
    13 Medicaid 8381 MAP-3014 Special Project Decision Notice No Response to Mailing
    13 Medicaid 8371 MAP-3014a Special Project Notice of Denial
    13 Medicaid 8374 MAP-3014b Special Project Acceptance Notice MA to MA or FHP to MA
    13 Medicaid 8375 MAP-3014d Special Project Acceptance Notice FHP to FHP or MA to FHP
    13 Medicaid 8368 MAP-3014e Special Project Acceptance Notice FHP to FHP or MA to FHP
    13 Medicaid 8377 MAP-3014f Special Project Renewal Status Notice MA to MA or FHP to MA
    13 Medicaid 8378 MAP-3014g Special Project Renewal Status Notice MA to MA or FHP to FHP
    13 Medicaid 8376 MAP-3014h Special Project Renewal Status Notice FHP to FHPor MA to FHP
    13 Medicaid 8391 MAP-3016 Request to Provide Income Information
    13 Medicaid 8393 MAP-3017 Notice Regarding Your Eligibility For MSP
    13 Medicaid 8495 MAP-3018 Confirmation Of Public Health Insurance
    13 Medicaid 8651 MAP-3018a Confirmation of Public Health Insurance Coverage/Case Level
    13 Medicaid 8480 MAP-3021 Nursing Home Renewal Cover Letter
    13 Medicaid 8675 MAP-3022 Nursing Home Renewal
    13 Medicaid 8484 MAP-3024 Follow-Up Request For Additional Proof/Information
    13 Medicaid 8485 MAP-3024a Follow-Up Request For Additional Proof/Information
    13 Medicaid 8606 MAP-3026a Retroactive Medicaid Need to Determine Financial Eligibility
    13 Medicaid 8650 MAP-3026b Notice of Decision Regarding Medical Bills ? MKB v Eggleston
    13 Medicaid 8586 MAP-3030 Notice of Deferral (MIIP)
    13 Medicaid 8592 MAP-3030 Notice of Deferral (MIIP)
    13 Medicaid 8593 MAP-3030a Final Notice of Deferral (MIIP)
    13 Medicaid 8587 MAP-3030a Final Notice of Deferral (MIIP)
    13 Medicaid 8604 MAP-3031 Request for Payment of Overpayment (TPPU)
    13 Medicaid 8607 MAP-3032 EDITS History Sheet
    13 Medicaid 8610 MAP-3035 Notice of Intent to Discontinue Medicaid (Birth Verification)
    13 Medicaid 8611 MAP-3035a Discontinue Medicaid/Family Health plus Coverage (OMR)
    13 Medicaid 8612 MAP-3035b Notice of Intent to Discontinue Medical Assistance
    13 Medicaid 8617 MAP-3036a Spousal Refusal Referral
    13 Medicaid 8711 MAP-3036b Investigation, Revenue and Enforcement Administration
    13 Medicaid 8613 MAP-3037 Investigation Revenue and Enforcement Administration (IREA)
    13 Medicaid 8649 MAP-3038 Notice of Responsibility (Guardianship)
    13 Medicaid 8648 MAP-3041 Denial of NAMI Adjustment Request
    13 Medicaid 8838 MAP-3041a Notice of Intent to Change Your Net Available Monthly Income
    13 Medicaid 8615 MAP-3043 Authorization to Apply for Medicaid on my Behalf
    13 Medicaid 8616 MAP-3044 Facility Submission of Application on Behalf of Consumer
    13 Medicaid 8618 MAP-3045 Ombudsman Unit Inquiry Form
    13 Medicaid 8644 MAP-3046 Request To Change Provider and/or Pharmacy
    13 Medicaid 8699 MAP-3046a Request to Change Provider/Pharmacy and or Dentist
    13 Medicaid 8647 MAP-3047 Notice of Denial of Your Application For MSP (Part B)
    13 Medicaid 8673 MAP-3047a Notice of Receipt of Medicare Savings Programs (MSP)
    13 Medicaid 8698 MAP-3047b Your Application/Enrollment in the Medicare Savings Program
    13 Medicaid 8839 MAP-3050 Note of Intent to Discontinue MA/FHP Coverage-Excess Resource
    13 Medicaid 8708 MAP-3051 NHED Conference Disposition Summary
    13 Medicaid 8709 MAP-3051a NHED Conference Request Summary
    13 Medicaid 8710 MAP-3053 Under-care Transmittal To The Medical Assistance Program
    13 Medicaid 8840 MAP-3053a Domestic Violence Transmittal to the MAP
    13 Medicaid 8747 MAP-3055 Postponed Case Actions - Hurricane Sandy Notices
    13 Medicaid 8852 MAP-3056 Response to Agency Conference Request (NHED)
    13 Medicaid 8853 MAP-3056a Failed to Attend Agency Conference (NHED)
    13 Medicaid 8794 MAP-3057 Special Income Standard for Housing Expenses
    13 Medicaid 8806 MAP-3060 Late Mailing of Your DAB Renewal Notification
    13 Medicaid 8834 MAP-3062 Acknowledgement of Your Request for a Time Extension (NHED)
    13 Medicaid 8818 MAP-3064 NHED REFERRAL TO IREA/OMPFAI
    13 Medicaid 8859 MAP-3069 Reconsideration Request (EDITS)
    13 Medicaid 8860 MAP-3069a Re-Application Submission (EDITS)
    13 Medicaid 7201 MAP-316 Fair Hearing Decision Notice
    13 Medicaid 7199 MAP-316A Fair Hearing Notice Accept Family Health Plus Application
    13 Medicaid 7202 MAP-316B Fair Hearing Notice Of Denial Of Medicaid/FHP
    13 Medicaid 7203 MAP-316C Fair Hearing Plan Selection Notice
    13 Medicaid 7204 MAP-316D Notice Of Use Of Old Excess Income (Surplus) Amount
    13 Medicaid 7210 MAP-316E Notice Of Retroactive Eligibility
    13 Medicaid 7211 MAP-316F Pre-Fair Hearing Summary
    13 Medicaid 7200 MAP-316G Fair Hearing Compliance Follow-Up Notice
    13 Medicaid 7489 MAP-316H Response To Rivera Request
    13 Medicaid 7490 MAP-316J Rivera Request Receipt/Intake
    13 Medicaid 8690 MAP-316k Notice to Re-Establish Medicaid
    13 Medicaid 7969 MAP-316P Withdrawal of NYS OTDA Fair Hearing Request
    13 Medicaid 7841 MAP-316Q Carfare Reimbursement Request FH
    13 Medicaid 5472 MAP-403 Medicaid Elig Deter-Request for Additional Information
    13 Medicaid 5600 MAP-403B Hospital Response to Request for Additional Info.
    13 Medicaid 7063 MAP-404 Notice of Non-Payment, TPHI Premium replaces MAP-2089J
    13 Medicaid 7205 MAP-404A TPD Document/Info Req. For Health Insurance Premium Paymnts
    13 Medicaid 7492 MAP-404B Certificate Of Group Health Plan Coverage
    13 Medicaid 8379 MAP-404e Notice of Removal of Third Party Health Insurance
    13 Medicaid 8118 MAP-404F Social Security Administration Referral Form
    13 Medicaid 6308 MAP-411 Notice of Medicaid Review Team
    13 Medicaid 5630 MAP-418R Request for Nursing Home Care/Heath-Related
    13 Medicaid 8396 MAP-480C Hospital Request to Lift Medicaid Managed Care
    13 Medicaid 8398 MAP-480V Request for Institutions for Mental Diseases-MD Disenrollment
    13 Medicaid 7834 MAP-480X Request for SSI/SSI-Related Newborn Disenrollment
    13 Medicaid 8643 MAP-5018 Self-Declaration of Income
    13 Medicaid 8674 MAP-555 Notice of Intent to Discontinue Health Insurance Coverage (QC)
    13 Medicaid 6881 MAP-570A Decision on Your Family Planning Benefit App.(Accept)
    13 Medicaid 7356 MAP-570B Decision Notice On MA Application (Family Planning Accept.)
    13 Medicaid 7357 MAP-570C (E-S) Minors Declaration Of Age (Family Planning Benefit)
    13 Medicaid 6882 MAP-570F Declination of Evaluation for Family Planning Benefit Prog
    13 Medicaid 7358 MAP-570G Decision Notice On Family Planning Benefit Only App. Denial
    13 Medicaid 7213 MAP-570J Family Planning Benefit Prog. (FPBP) Renewal
    13 Medicaid 7573 MAP-58f Facilitated Enrollment Sites
    13 Medicaid 8131 MAP-58j List of Facilitated Enrollers and Medicaid Renewal Site
    13 Medicaid 6875 MAP-628 Single Item Checklist
    13 Medicaid 6832 MAP-628A Mail Renewal Checklist
    13 Medicaid 6833 MAP-628B Mail Renewal Case Status Update Sheet
    13 Medicaid 7030 MAP-628C MBI-WPD Documentation Checklist
    13 Medicaid 7392 MAP-628F Resource Checklist For Long-Term Care Upgrade
    13 Medicaid 8112 MAP-628K FERU Case Action Review Checklist
    13 Medicaid 8404 MAP-635 Notice of Deferral/Separate Determination
    13 Medicaid 7897 MAP-635A Child Health Referral
    13 Medicaid 7491 MAP-635B Referral To Legal Affairs Office/Revenue And Investigation
    13 Medicaid 7049 MAP-635D Referral to Child Support Enforcement Unit CSEU
    13 Medicaid 7522 MAP-635G MSP Referral For Correct Documentation From SSA
    13 Medicaid 7520 MAP-635H (ES) Non Public Assistance Food Stamp Appointment Notice
    13 Medicaid 7560 MAP-635J Medicaid/Family Health Plus Renewal
    13 Medicaid 8032 MAP-635K Notice of Deferral (Application)
    13 Medicaid 7527 MAP-635M Conference Unit Client Referral
    13 Medicaid 7528 MAP-635N Notice of Deferral Pooled Trust
    13 Medicaid 8033 MAP-635Q Notice if Second Deferral (Application)
    13 Medicaid 8419 MAP-635S Notice of Deferral
    13 Medicaid 8481 MAP-635U Mail Renewal Reminder (PTM for FHPlus)
    13 Medicaid 8787 MAP-647W Transmittal of Enrollment Status for CHP Applicants
    13 Medicaid 8056 MAP-648E Pooled Trust Case Transmittal
    13 Medicaid 7894 MAP-648M Inter-Agency (DOS) and (DEC) Transmittal Form
    13 Medicaid 7842 MAP-648P Transmittal for Nursing Medicaid Application
    13 Medicaid 8645 MAP-648r Substantial Home Equity Referral
    13 Medicaid 8261 MAP-648S Match Information for Consumers Born in Puerto Rico
    13 Medicaid 7369 MAP-649G CHP B Managed Care Enrollment Transmittal
    13 Medicaid 7225 MAP-649K NHED NAMI Reporting Transmittal
    13 Medicaid 7226 MAP-649L MLTC Disenrollment Reporting Transmittal
    13 Medicaid 7224 MAP-649U Fair Hearing Transmittal To Reimbursement Unit
    13 Medicaid 8111 MAP-700 Medicaid Case Action Review Worksheet
    13 Medicaid 7826 MAP-713 Notice of Acceptance of Your Medical Assistance Application
    13 Medicaid 7827 MAP-713A Notice of Change To Your Medical Assistance Coverage
    13 Medicaid 7828 MAP-713B Notice of Change To Your Medical Assistance Coverage
    13 Medicaid 7829 MAP-713C Notice of Discontinuance of Medical Assistance Coverage
    13 Medicaid 7830 MAP-713D Notice of Discontinuance of Medical Assistance Coverage
    13 Medicaid 7831 MAP-713E Notice of Discontinuance of Medical Assistance Coverage
    13 Medicaid 7832 MAP-713F Notice of Discontinuance of Medical Assistance Coverage
    13 Medicaid 8117 MAP-713G Discontinuance of Medicaid Coverage S/CC
    13 Medicaid 8084 MAP-713H No Longer Meets the Medical Improvement Group Requirements FP
    13 Medicaid 8085 MAP-713J No Longer Meets the Medical Improvement Group Requirements
    13 Medicaid 8086 MAP-713K MBI-WPD Medical Improvement Group
    13 Medicaid 8087 MAP-713M Under the MBI-WPD Medical Improvement Group (Work/Wage-FNP
    13 Medicaid 8115 MAP-713N Discontinuance of Medicaid Coverage Work/Wage-FP
    13 Medicaid 8116 MAP-713P Discontinuance of Medicaid Coverage Work/Wage-S/CC
    13 Medicaid 5817 MAP-751 Hospital Request to Change Client Information on File
    13 Medicaid 6883 MAP-751A Provider Request to Change Client Information On File
    13 Medicaid 7042 MAP-751B Consumer Request To Change Address/Telephone Number
    13 Medicaid 6874 MAP-751C Request Access Medicaid Info/Exercise HIPAA Privacy Rights
    13 Medicaid 8522 MAP-751c Request for Health Insurance Information
    13 Medicaid 6873 MAP-751D Disclosure Authorization Of Individual Health Information
    13 Medicaid 6935 MAP-751E Authorization to Release Medical Information
    13 Medicaid 6936 MAP-751F Authorization for Release of Confidential HIV Related Info
    13 Medicaid 7208 MAP-751G Response To Consumer Request For Change
    13 Medicaid 7319 MAP-751J Feau/Feru Request For Case Correction
    13 Medicaid 7895 MAP-751K Consumer Request to Change Information on File
    13 Medicaid 7843 MAP-751N Limited Power of Attorney
    13 Medicaid 7840 MAP-751P Consent to Release Information
    13 Medicaid 7984 MAP-751Q Request to Update Case Records
    13 Medicaid 8385 MAP-751u Response to Your Request for Health Insurance Information
    13 Medicaid 5423 MAP-779 Authorization to Receive Distribute Medicaid Card
    13 Medicaid 7393 MAP-802V Surplus Income Log (Replaces MAP-2069B)
    13 Medicaid 7835 MAP-900 Request For Additional Information (Medicaid MC)
    13 Medicaid 7889 MAP-900A Notice of Decision on your Medical Assistance Application
    13 Medicaid 8400 MAP-900G Certification of On-Line Renewal
    13 Medicaid 8496 MAP-908c Notice of Intent to Discontinue MA (Transitional Medicaid)
    13 Medicaid 5581 MAP-909 Notice to Former SSI Beneficiary
    13 Medicaid 7227 MAP-909A (E-S) Notice To Former CA Applicant: Schedule MA Interview
    13 Medicaid 7228 MAP-909B Notice To Schedule Interview For Medicaid (Closed Cases)
    13 Medicaid 7359 MAP-909C (E-S) Notice Schedule MA Interview (Separate Determination)
    13 Medicaid 7494 MAP-909E DAB Renewal Notification-Medicaid Managed Long Term Care
    13 Medicaid 7672 MAP-909F Medicare Savings Program Renewal Notification
    13 Medicaid 5582 MAP-931B Agreement to Participate in the Medicaid Pay-In Program
    13 Medicaid 7361 MAP-931D Refund Notice Due 2 Review Of Your MA Claims (Pay-In-Prgrm)
    13 Medicaid 7317 MAP-931E Notice Of Review Of MA Claims (Pay-In-Program)
    13 Medicaid 6229 MAP-931G Surplus Income Program Decision Coverage not Authorized Pay in
    13 Medicaid 6885 MAP-931J How to Apply: MA's Excess Income/Resource Program or FHP
    13 Medicaid 7064 MAP-931N Notice of Excess Resources replaces MAP-2159E
    13 Medicaid 7212 MAP-931T Explanation Of Your Medicaid Coverage Level (RVI)
    13 Medicaid 8109 MAP-931Y Surplus Fax Medical Bills
    13 Medicaid 7137 MAP-992C Notice Of Conversion From FHP To MA Excess Income Program
    13 Medicaid 7363 MAP-992D Notice Of Conversion From FHP To MA Excess Income Program
    13 Medicaid 7364 MAP-992E Notice Of Conversion From FHP To MA Excess Resource Program
    13 Medicaid 7136 MAP-992F Notice Of Conversion From Family Health Plus To Medicaid
    13 Medicaid 7365 MAP-992G Notice Of Cancellation Of Family Health Plus Coverage
    13 Medicaid 8022 MAP-992H Notice of Discontinuance of FH Plus Coverage
    13 Medicaid 8042 MAP-992J Notice of Change-Medicaid Income to MBI-WPD
    13 Medicaid 8609 MAP-992k Medicaid Excess Income/Resources Program Return Check Notific
    13 Medicaid 5709 MAP-HHC On-Site Demo Project Case Tracking Form MAP/E H917
    13 Medicaid 7890 MAP-U0177 Notice to Reinstate Medical Assistance Coverage
    13 Medicaid 7893 MAP-U0181 Notice to Reinstate Medical Assistance Coverage
    13 Medicaid 7891 MAP-U0182 Notice to Reinstate Family Planning Benefit Program
    13 Medicaid 5583 MAP/E 2201 Employment History Sheet
    13 Medicaid 5856 MAP/E 40036 Documentation Request
    13 Medicaid 5710 MAP/E C1080 Medical Assistance Program Community
    13 Medicaid 5909 MAP/E C1435 Supervisory Check Off List
    13 Medicaid 5858 MAP/E C218A Eligible for Medicare Under Aid to Disabled Program
    13 Medicaid 5876 MAP/E C794 Medicaid Documentation Request/Recertification
    13 Medicaid 5886 MAP/E C931 Notice of Decision
    13 Medicaid 5882 MAP/E C992A Monthly Surplus Decision
    13 Medicaid 5584 MAP/E E201 Employ Doc
    13 Medicaid 5837 MAP/E E22 We cannot arrive at a decision Request for Information
    13 Medicaid 5903 MAP/E E305 Routing/ Referral Slip
    13 Medicaid 5674 MAP/E E672 Application Review
    13 Medicaid 5842 MAP/E E713 Bank Inquiry and Report
    13 Medicaid 5585 MAP/E H 920 Case Submission Sheet
    13 Medicaid 5588 MAP/E H403B Request for Additional Information
    13 Medicaid 5875 MAP/E H914 MAP-HHC On Site DemoProj notification prior case report
    13 Medicaid 5874 MAP/E H921 MAP-HHC On Site DemoProj notification errors to HHC
    13 Medicaid 5695 MAP/E H955 Hospital Eligibility Tracking System Referral Form
    13 Medicaid 5704 MAP/E Intake Clearance and Control Notice to Former SSI Beneficiary
    13 Medicaid 5850 MAP/E L960 Chronic Care Recertification
    13 Medicaid 5888 MAP/E MS411 Notice of Determination for Aid to Disabled Category
    13 Medicaid 7959 MAPMKB-402-E MKB Notice of Medicaid Determination Form
    13 Medicaid 7844 MC Exemption Request Back-File Packet
    13 Medicaid 7845 MC Exemption Request Packet
    13 Medicaid 5619 Medicaid Documentation Guide
    13 Medicaid 5821 Medicaid Recertification
    13 Medicaid 5776 Medicaid Resource History
    13 Medicaid 8473 Medicaid Wavier (any kind)
    13 Medicaid 6222 Medical Assistance Program Verification Guide
    13 Medicaid 5752 Medical Assistance Questionnaire Responsible Relative
    13 Medicaid 5594 Medical Eligibility Program Letter -If we do not hear from you within 2 weeks
    13 Medicaid 7215 Medical Records
    13 Medicaid 5526 Medicare Buy-In Deletion Transmittal
    13 Medicaid 5813 Medicare Buy-in Request for Active Medicaid Recipients
    13 Medicaid 5595 MEP 2105A In Request for Information Concerning Your Income
    13 Medicaid 5879 MEP 2127A Medicaid Home Care Control Card
    13 Medicaid 6343 MEP-205 Transmittal for Health Maintenance Organizations - Enrollments
    13 Medicaid 5871 MEP-2080 Institutional Services Control Form
    13 Medicaid 5593 MEP-2105A HR Human Resource Administration Medicaid Elig Program
    13 Medicaid 5686 MEP-2158A Dear Health Care Provider Letter
    13 Medicaid 5598 MEP-2159F Medicare Optimization
    13 Medicaid 5681 MEP-2162A Client Data Form Household Information
    13 Medicaid 5914 MEP-2162D Transmittal for Medicaid Eligibility for Pregnant Women
    13 Medicaid 5601 MEP-403B Add Request for Additional Information
    13 Medicaid 5508 MEP-418R Request for Medical Assistance
    13 Medicaid 5602 MEP-649 Transmittal to Medicaid Eligibility Program
    13 Medicaid 6178 MIC Appointment Book
    13 Medicaid 7850 MKB Medicaid Retroactive Relief Packet
    13 Medicaid 6489 MRT Plan of Care
    13 Medicaid 8703 MSP Conversion For MLTC Enrollment
    13 Medicaid 8572 Neurology Lab
    13 Medicaid 5625 New York Hospital Based Certification for an Application for Medical Assistance
    13 Medicaid 8664 NHD Budget Revision Letter
    13 Medicaid 8141 NHD Legal Referral Packet
    13 Medicaid 8628 Non-Negotiable Promissory Note
    13 Medicaid 5884 Notice of Action on Application Benefit for the Medicaid Buy-in Progr
    13 Medicaid 5788 Notice of Appointment for Consultive Examination
    13 Medicaid 5798 Notice of Change in Hospital Care Liability
    13 Medicaid 8474 Notice of Decision for FHP ? Premium Assistance
    13 Medicaid 5627 Notice of Decision on Your Medical Assistance
    13 Medicaid 8171 Notice of Decision to Discontinue Your Medical Assistance
    13 Medicaid 5624 Notice of Determination of Non-Entitlement to Benefits
    13 Medicaid 5758 Notice of Eligibility/Recertification for Medicaid
    13 Medicaid 8785 Notice of MA Disability Determination ? MBI-WPD Basic Group
    13 Medicaid 5822 Notice of Medicaid Recertification
    13 Medicaid 5891 Notice of Reduction Discontinuance Receipt of Social Security Benefit
    13 Medicaid 5892 Notice Requirement to Provide Documents-Resources at Recertification
    13 Medicaid 5767 Notice to Patient Accounts Staff Regarding Disposition of Corresponded
    13 Medicaid 5814 Notification of Change or Correction to File from RHCF
    13 Medicaid 5783 Notification of Pending Personal Injury or Negligence Law Suit
    13 Medicaid 7971 NYC Department of Corrections DOC Inmate Identification Card
    13 Medicaid 8707 NYS DOH Medicaid Service Coordination Notice
    13 Medicaid 7507 NYS DOH Recipient Demographic Report RRP
    13 Medicaid 8602 NYS DOH-4287 Continuing Your Medicaid or Family Health plus Benefits
    13 Medicaid 6423 NYS Medicaid Eligibility Current Record Report
    13 Medicaid 8412 NYS Worker?s Compensation Board ? Medical exam form
    13 Medicaid 8402 NYSDOH-435 Discontinue the Care at Home I and II Waiver NYC-Only
    13 Medicaid 8573 Obstetrics/Gynecology Lab
    13 Medicaid 6618 Office of Medicaid Management Newborn Input Form or Worksheet
    13 Medicaid 8169 OHIP-0035 NYC Medicaid Part D
    13 Medicaid 8472 OHIP-0044 Denial for the Medicare Savings Program (SSA)
    13 Medicaid 8502 OLA / Attorney Correspondence
    13 Medicaid 8142 OLA Legal Recommendation
    13 Medicaid 8567 Orthopedics Lab
    13 Medicaid 8571 Other Specialty Lab
    13 Medicaid 6113 Out-patient referral for admission to wards
    13 Medicaid 8654 Personal Care Services Contract
    13 Medicaid 8499 Petition for Pooled Trust
    13 Medicaid 8577 Physiatry Lab
    13 Medicaid 8836 PIMM Communications Deferral Alert
    13 Medicaid 8500 Pooled Trust
    13 Medicaid 8501 Pooled Trust Deposits
    13 Medicaid 5826 Program Referral
    13 Medicaid 8574 Psychiatry Lab
    13 Medicaid 8570 Pulmonology Lab
    13 Medicaid 5896 Quality Control Workbook Face Sheet
    13 Medicaid 5902 Raquest to Accept a Medicaid Application for a PA Case Denial Closed
    13 Medicaid 5626 Reason for Application or Past Maintenance or Supplemental Information
    13 Medicaid 5897 Reason for Application Past Maintenance Supplemental Information
    13 Medicaid 5829 Reassessment Center Referral Letter
    13 Medicaid 5497 Recertification Guide for the Medical Assistance Face to Face Interview
    13 Medicaid 5498 Recertification Statement
    13 Medicaid 5499 Recertification Statement Continued Medicaid Coverage for Newborn Babies
    13 Medicaid 7506 Recipient Detail Request Report RRP
    13 Medicaid 5835 Referral for Medicaid or Home Care Services
    13 Medicaid 6497 Registered Nurse's Certification
    13 Medicaid 5622 Release of Confirmation Statement and Uniform Assignment
    13 Medicaid 8413 Relocation Referral Notice
    13 Medicaid 5778 Reminder of Recertification Appointment
    13 Medicaid 5617 Report of BEV Applicant Recommendation
    13 Medicaid 5503 Request for Additional Information Medicaid
    13 Medicaid 5750 Request for Compliance
    13 Medicaid 5786 Request for Documentation or Information for Recertification
    13 Medicaid 5881 Request for Employee Benefits Information
    13 Medicaid 6498 Request for Exception Receive Personal Care Services Physician's Cert
    13 Medicaid 5811 Request for Financial Assessment
    13 Medicaid 5802 Request for Long Term Care
    13 Medicaid 5901 Request for New Physician's Statement of Determination of Disability
    13 Medicaid 8575 Rheumatology Lab
    13 Medicaid 5801 Scheduled Appointments for SACC Assessments
    13 Medicaid 7939 Self attestation for Rikers Inmates
    13 Medicaid 5730 Single Item Collection Division of Accounts Receivable and Billing
    13 Medicaid 5741 Social Statement for Determination of Disability
    13 Medicaid 8545 Specialty Medical Obstetrics/Gynecology (16AO)
    13 Medicaid 8559 Specialty Medical Obstetrics/Gynecology (96AO)
    13 Medicaid 8536 Specialty Medical Cardiology (16AC)
    13 Medicaid 8550 Specialty Medical Cardiology (96AC)
    13 Medicaid 8537 Specialty Medical Dermatology (16AD)
    13 Medicaid 8551 Specialty Medical Dermatology (96AD)
    13 Medicaid 8538 Specialty Medical Endocrinology (16AE)
    13 Medicaid 8552 Specialty Medical Endocrinology (96AE)
    13 Medicaid 8540 Specialty Medical Gastroenterology (16AG)
    13 Medicaid 8554 Specialty Medical Gastroenterology (96AG)
    13 Medicaid 8548 Specialty Medical General Surgery (16AS)
    13 Medicaid 8562 Specialty Medical General Surgery (96AS)
    13 Medicaid 8541 Specialty Medical Hematology/Oncology (16AH)
    13 Medicaid 8555 Specialty Medical Hematology/Oncology (96AH)
    13 Medicaid 8544 Specialty Medical Neurology (16AN)
    13 Medicaid 8558 Specialty Medical Neurology (96AN)
    13 Medicaid 8539 Specialty Medical Orthopedics (16AF)
    13 Medicaid 8553 Specialty Medical Orthopedics (96AF)
    13 Medicaid 8543 Specialty Medical Other Specialty (16AM)
    13 Medicaid 8557 Specialty Medical Other Specialty (96AM)
    13 Medicaid 8549 Specialty Medical Physiatry (16AT)
    13 Medicaid 8563 Specialty Medical Physiatry (96AT)
    13 Medicaid 8546 Specialty Medical Psychiatry (16AP)
    13 Medicaid 8560 Specialty Medical Psychiatry (96AP)
    13 Medicaid 8542 Specialty Medical Pulmonology (16AL)
    13 Medicaid 8556 Specialty Medical Pulmonology (96AL)
    13 Medicaid 8547 Specialty Medical Rheumatology (16AR)
    13 Medicaid 8561 Specialty Medical Rheumatology (96AR)
    13 Medicaid 5603 SSA - Application for a Social Security Card
    13 Medicaid 8789 SSA ERE Document
    13 Medicaid 5629 SSA-1099 SM Social Security Benefit Statement
    13 Medicaid 5906 SSA-1099 Social Security Benefit Statement
    13 Medicaid 7792 SSA-16 Application for Disability Insurance Benefits
    13 Medicaid 5605 SSA-2458 Report of Confidential Social Security Benefit Information
    13 Medicaid 6575 SSA-3199-SM Your Medicare Premium Refund
    13 Medicaid 6411 SSA-3368-BK Part II Information About Your Medical Records
    13 Medicaid 6201 SSA-3368-F6 Disability Report
    13 Medicaid 8164 SSA-4814-F5 Medical Report on Adult with Allegation of HIV Infection
    13 Medicaid 8165 SSA-4815-F6 Medical Report on Child with Allegation of HIV Infection
    13 Medicaid 5913 SSA-491TC TPQY Input
    13 Medicaid 5606 SSA-4926 SM SSA How we figured your new appointment amount
    13 Medicaid 5658 SSA-7028 Third Party of Social Security Number-Notice to
    13 Medicaid 5645 SSA-L30 SSA Retire Survivors and Disability Insurance Notice of Award
    13 Medicaid 5652 SSA-L30-CI Social Security Award Certificate
    13 Medicaid 6570 SSA-L444 Supplemental Security Income Notice
    13 Medicaid 8705 SSA-L8125 SSI Notice of Interim Assistance Reimbursement
    13 Medicaid 5607 SSAL8025 SSA Supplemental Security Income Notice of Award
    13 Medicaid 8414 State Medicaid Verification
    13 Medicaid 5791 Statement of Medicaid Authorization and Surplus Income
    13 Medicaid 5745 Sterilization Consent Form
    13 Medicaid 8581 Supp DVE (16SD)
    13 Medicaid 8122 Supplement Needs Trust - OLA Correspondence
    13 Medicaid 6869 Supplemental Info Office of Children and Family Services' Youth
    13 Medicaid 8585 Surplus E-Fax Packet
    13 Medicaid 8389 Third Part - MSP Referral
    13 Medicaid 8387 Third Party - NFA Request
    13 Medicaid 8388 Third Party - Request ready for processing
    13 Medicaid 5747 Third Party Health Insurance Data Entry Form
    13 Medicaid 8193 Third Party Packet
    13 Medicaid 5789 Transmittal for Medicaid Community Care/New Applications
    13 Medicaid 5815 Transmittal for Presumptive Medicaid Eligibility for Pregnant Women
    13 Medicaid 5673 W- Application for Short Term Home Relief Child Hospitalized Beyond
    13 Medicaid 5728 W-132N Referral to Medicaid Office from Job Center
    13 Medicaid 6050 W-132P Income Support Program Dear Medicaid Recipient.
    13 Medicaid 7496 W-148A Authorization PA Reimbursement f or SSI Retroactive Paymnt
    13 Medicaid 5670 W-180F Administration for Children's Services
    13 Medicaid 5647 W-180G Hospital Home Relief Notice
    13 Medicaid 5613 W-2-112 As a MA Claiment u r allowed to establish a Burial Fund
    13 Medicaid 5468 W-270E MAP Program Referral Tracking
    13 Medicaid 5608 W-296E Medicaid Recertification
    13 Medicaid 5474 W-296N Medicaid Recertification
    13 Medicaid 6189 W-34D B-M-A Referral Form
    13 Medicaid 5682 W-435 Code 4A Registry Transmittal
    13 Medicaid 6495 W-441 PERS Installation Removal or Re-Installation Transmittal
    13 Medicaid 6436 W-477D Medicaid Managed Health Care Program Enrollment
    13 Medicaid 8792 W-480D Uniform Request to add Unborns to Managed Care Cases
    13 Medicaid 6781 W-480F Undercare Managed Care Benefit Code or Case Number Change
    13 Medicaid 6771 W-480G Managed Care Enrollment Transmittal
    13 Medicaid 7324 W-480Q Hosp. Req to Lift Managed Care Enroll Serv. During Elig. Gap
    13 Medicaid 5614 W-506 Real Property Information
    13 Medicaid 5715 W-560 Notice of Approval of Second Transition and Medicaid Extension
    13 Medicaid 5877 W-586K Medicaid Field Investigation Report
    13 Medicaid 5611 W-589 Acc Account Information-Request
    13 Medicaid 5885 W-589C Notice of Continuation of your Medical Assistance Coverage
    13 Medicaid 5677 W-663B Authorization for Medical Assistance
    13 Medicaid 5862 W-663B Batch Transmittal MAP 2064
    13 Medicaid 6202 W-694 DSS-515 Addendum
    13 Medicaid 6251 W-884 Special Exceptional Care Authorization
    13 Medicaid 6223 W-8848 Medical or Psychiatric Certification
    13 Medicaid 7399 W-930 HomeCare Services Program CASA Control Form
    13 Medicaid 8833 W2 Correspondence Letter
    13 Medicaid 5772 WARNRPT RPT Long term Home Health Care System rejects By Vendor ID
    13 Medicaid 5592 Welfare Public Assistance - Welfare Reform
    13 Medicaid 8578 Wellness Plan Extension
    13 Medicaid 6177 WIC Appointment Book
    13 Medicaid 5522 WINRO 728 Case Eligibility Review Document CERD
    13 Medicaid 5942 Work Readiness
    13 Medicaid 5618 Worker Checklist for Medical Assistance
    13 Medicaid 5615 XL-0218 Decision on Your Medical Assistance-Notice of
    14 RAU 6857 RAU Movers Inventory List
    14 RAU 7956 RAU Packet
    14 RAU 6853 RAU Special Factors or Correspondences
    14 RAU 6862 RAU Three Estimates from Licensed Movers
    14 RAU 6855 RAU Unified Court System printout
    14 RAU 6858 RAU W-145N Request for Emergency Assistance
    14 RAU 6859 RAU W-146E Excess Rent & Third Party Proof of Income
    14 RAU 6861 RAU W-147BB Request for Approval of Special Grant 22
    14 RAU 6854 RAU W-153Q Notice Of Approval On The Request To Rental Assistance Unit
    14 RAU 6856 RAU W-153T Notice Of Denial On The Request To The Rental Assistance
    14 RAU 6860 RAU WMS Printout
    14 RAU 7594 W-150R APS Rental Assistance Unit Exception to Policy Request
    15 BEV 7272 BEV Employment Business Records
    15 BEV 7269 BEV Employment Current Wage Stubs
    15 BEV 7271 BEV Employment Employer Verification
    15 BEV 7268 BEV Employment Pay Envelopes
    15 BEV 7266 BEV Employment Pay Stubs
    15 BEV 7267 BEV Employment Tax Returns submitted by client
    15 BEV 7270 BEV Employment/Income Unemployment UIB
    15 BEV 7249 BEV Identity Adoption Papers/Records
    15 BEV 7250 BEV Identity Birth Certificate or Baptismal Records
    15 BEV 7252 BEV Identity Death Certificate
    15 BEV 7245 BEV Identity Driver's License
    15 BEV 7248 BEV Identity Hospital or Doctor's Records
    15 BEV 7247 BEV Identity Naturalization Certificate
    15 BEV 7253 BEV Identity Official Correspondence from SSA
    15 BEV 7255 BEV Identity Other
    15 BEV 7246 BEV Identity Passport
    15 BEV 7385 BEV Identity Permanent Resident Card
    15 BEV 7244 BEV Identity Photo ID
    15 BEV 7251 BEV Identity Social Security Card or DSS-400
    15 BEV 7254 BEV Identity VA or Military Records
    15 BEV 7259 BEV Marital Status Court Records
    15 BEV 7258 BEV Marital Status Divorce Decree
    15 BEV 7256 BEV Marital Status Marriage or Death Certificates
    15 BEV 7386 BEV Marital Status Other
    15 BEV 7257 BEV Marital Status Separation Agreement
    15 BEV 7281 BEV Notebook ALERTS
    15 BEV 7261 BEV Residence Current Rent Receipt or Lease
    15 BEV 7263 BEV Residence Driver's Registration
    15 BEV 7265 BEV Residence Mortgage Records or Bank Statement
    15 BEV 7388 BEV Residence Other
    15 BEV 7260 BEV Residence School Records
    15 BEV 7262 BEV Residence Statement from Landlord
    15 BEV 7277 BEV Resources Burial plot deed
    15 BEV 7273 BEV Resources Current bank or credit union records
    15 BEV 7279 BEV Resources Deed
    15 BEV 7276 BEV Resources Insurance policy
    15 BEV 7391 BEV Resources Other
    15 BEV 7275 BEV Resources Statement from financial institution
    15 BEV 7278 BEV Resources Statement from funeral director
    15 BEV 7274 BEV Resources Stock or Bond certificate
    15 BEV 7280 BEV Resources Tax Refund or EITC check
    15 BEV 6376 BEV W-585G Notice to Telephone BEV
    15 BEV 6377 BEV W-585K BEV Interview and Recommendation Worksheet
    15 BEV 7107 BEV W-585P or BEV 30 BEV Client Address Info Request Letter
    15 BEV 7484 BEV W-585Z Withdrawal of Application
    15 BEV 6737 BEV W-586F BEV-FA Undercare or Applicant Child Verification Ins
    15 BEV 7110 BEV W-588D BEV recommendation Application or Undercare data entry
    15 BEV 7485 BEV W-592G Employment or Wages Verification
    15 BEV 7367 BEV W-593H Appendix B ALERTS-Application
    15 BEV 7368 BEV W-593J Appendix B 1 ALERTS-Application
    15 BEV 5199 BEV- W-532T Eligibility Verification Review Questionnaire
    15 BEV 8308 BEV-100 Notice Real Property Ownership Appointment
    15 BEV 8815 BEV-230 SNAP Front End Detection System Request for Information
    15 BEV 5367 BEV-W-585R BEV Investigative Notes
    15 BEV 5952 W-532DD FA Eligibility Verification Review BEV EVR Question
    15 BEV 6120 W-585B Notice of Compliance with BEV Appointment
    15 BEV 6013 W-585W BEV Not at Home Notice
    16 Home Visit/Homebound Documentation 8584 CAS-104 Home Visit Needed Request Reviewer Outcome Form
    16 Home Visit/Homebound Documentation 8411 CAS-311 Home Visit Needed Assessment Cancellation (We Care)
    16 Home Visit/Homebound Documentation 8591 CAS-316 New Service Provider (WeCare Program)
    16 Home Visit/Homebound Documentation 8488 FIA-1028h Notice of Scheduled Home Visit
    16 Home Visit/Homebound Documentation 8490 FIA-1028i Documentation Request for Home Visits Homebound
    16 Home Visit/Homebound Documentation 8802 FIA-1028j Notice to Individuals Requesting Home Visit Needed HVN/HB
    16 Home Visit/Homebound Documentation 8489 FIA-1028k Notification of Expiration of Home Visit Homebound
    16 Home Visit/Homebound Documentation 8800 FIA-1028L Liaison Checklist of Required Documents for CAS Review
    16 Home Visit/Homebound Documentation 8714 FIA-1086f Referral to Back to Work (B2W) Vendor
    16 Home Visit/Homebound Documentation 8655 HRA-102a Reasonable Accommodation Request (RAR) Form
    16 Home Visit/Homebound Documentation 8656 HRA-102b RAR Conformation Notice
    16 Home Visit/Homebound Documentation 8619 HRA-104 Determination of Your Reasonable Accommodation Request
    16 Home Visit/Homebound Documentation 8620 HRA-105 Denial of Reasonable Accommodation No Medical Documentation
    16 Home Visit/Homebound Documentation 8791 HRA-108 HIPPA Authorization for Disclosure of Health Info
    16 Home Visit/Homebound Documentation 7578 Other Proof of Homebound Status
    16 Home Visit/Homebound Documentation 8657 RAR Medical Documentation
    02 Housing Information 6715 1900 Rent Arrears Request
    02 Housing Information 6680 Arrears Settlement or DVP Request Form
    02 Housing Information 6735 Broker's Fee Voucher -Memo
    02 Housing Information 5818 Calculation of Rent - any document showing how the rent is calculated
    02 Housing Information 6734 Certification of Rent Payment - Memo
    02 Housing Information 0268 Clinic Card Immunization Record with Current Address
    02 Housing Information 7190 CM-621c Worksheet For Computing Special Grant Housing Subsidy
    02 Housing Information 7191 CM-621f Notice to Landlord of Monthly Rent Subsidy
    02 Housing Information 8668 Copy of Broker?s License
    02 Housing Information 7295 Copy of money order for contribution toward rent arrears
    02 Housing Information 5362 Copy of Rent Payment Check
    02 Housing Information 7287 Court-ordered Stipulation with LT or Index Number (rent arrears)
    02 Housing Information 0328 Current Lease
    02 Housing Information 6820 Current Mail w current address need one add'l document
    02 Housing Information 0288 Current Rent Receipt
    02 Housing Information 0260 Current Report Card
    02 Housing Information 0256 Current School Letter with Current Address
    02 Housing Information 0304 Deed to home
    02 Housing Information 1036 DHS Referral to Income Support Center
    02 Housing Information 8669 Documentation of SCRIE or DRIE in effect to freeze rent level
    02 Housing Information 8670 Documentation of SCRIE or DRIE pending applications
    02 Housing Information 6605 FHC-245 R1 NYC Dept. of HPD voucher or Cert Section 8 Subsidy
    02 Housing Information 8302 FIA-1010 Corrective Measures Initiated
    02 Housing Information 8300 FIA-1017 Notice of Decision on Security Voucher Claim
    02 Housing Information 8477 FIA-1037 Assignment of Security Deposit
    02 Housing Information 8478 FIA-1038 Acknowledgment of Assignment of Security Deposit
    02 Housing Information 6723 Heating Benefit Calculation Worksheet
    02 Housing Information 0308 Home Insurance Policy
    02 Housing Information 6733 Homeless Prevention Legal Services/Request Re-Review EAF Certification
    02 Housing Information 0284 Hotel Receipt
    02 Housing Information 8293 Housing Package/Documentation HASA
    02 Housing Information 7409 HPD Rent Subsidies Recertification Declaration Form
    02 Housing Information 6682 HPD TAS Office of Property Management Printout
    02 Housing Information 6681 HPD Three Day Notice
    02 Housing Information 7222 HSP Apartment Acceptance Form
    02 Housing Information 7219 HSP Ineligibility Form
    02 Housing Information 7223 HSP Inspection Checklist
    02 Housing Information 7220 HSP Landlord's Statement
    02 Housing Information 7221 HSP Lease Rider
    02 Housing Information 8471 HUD Lease Addendum
    02 Housing Information 7310 Landlord Breakdowns
    02 Housing Information 0276 Landlord Letter Statement from Non-Relative Landlord
    02 Housing Information 0324 Landlord Notice Court Document
    02 Housing Information 0286 Letter from Facility
    02 Housing Information 7185 Letter Seeking contribution for Rent Arrears
    02 Housing Information 6194 MAP 1124A Clients Intent to Return Home
    02 Housing Information 0300 Mortgage Statement Receipt
    02 Housing Information 7294 Nonprofit Org official letterhead stating contribution toward arrears
    02 Housing Information 7290 Notice of Motion rent arrears
    02 Housing Information 7288 Notice of Petition rent arrears
    02 Housing Information 6695 Notice to Landlord of Two-Party Check Correction
    02 Housing Information 6607 NYCHA - Section 8 Existing housing Program
    02 Housing Information 6714 NYCHA History Sheet Telephone Review
    02 Housing Information 0292 NYCHA Rent Book Letter from Housing Manager
    02 Housing Information 6711 NYCHA Worksheet for Re-Housed Hotel or Shelter Cases
    02 Housing Information 7316 NYS OTDA FEPS Approval Letter
    02 Housing Information 8258 ODVEIS-1 Advantage Program Continuation Appointment
    02 Housing Information 8356 ODVEIS-3 Advantage Rental Supplement Appointment
    02 Housing Information 8363 ODVEIS-6 Advantage Program Continuation Decision Notice
    02 Housing Information 8362 ODVEIS-7 Advantage Program Continuation Approval Notice
    02 Housing Information 8361 ODVEIS-8 Advantage Program Continuation Deferral Notice
    02 Housing Information 8364 ODVEIS-9 Advantage Program Continuation Denial Notice
    02 Housing Information 8267 ODVEIS-IdE Advantage Program Continuation Denial Notice
    02 Housing Information 6616 Office of Community Services Referral - Leased Housing Match
    02 Housing Information 6617 Office of Community Services Referral - Section 8 Referral
    02 Housing Information 7291 Order to Show Cause rent arrears
    02 Housing Information 1692 Other Acceptable Document detailing housing related benefits
    02 Housing Information 0280 Other Document Containing Child's Name and Current Address
    02 Housing Information 7309 Other document supporting rent arrears payment request
    02 Housing Information 0334 Other Proof of Residency
    02 Housing Information 7289 Petition rent arrears
    02 Housing Information 0480 Proof of Additional Expenses
    02 Housing Information 0272 Recent Letter from Doctor Clinic etc with Current Address
    02 Housing Information 6709 Removal of Rent From DHS Shelter or Hotel Case
    02 Housing Information 7170 Rental History Breakdown from Landlord
    02 Housing Information 1600 Request for Approval of Special Grant 22 Moving Expenses
    02 Housing Information 6732 Request for check - Cooperative Apartment Programs
    02 Housing Information 1084 School Statement of Enrollment
    02 Housing Information 6736 Security Deposit Agreement - Memo
    02 Housing Information 6819 Statement from Another Person Re Current Residence-need 1 add'l doc
    02 Housing Information 6901 Statement from Another Person Re Residence
    02 Housing Information 1132 Statement from Financial Institution Lender
    02 Housing Information 1120 Statement from Landlord regarding New Apt Security Deposit
    02 Housing Information 1096 Statement from Licensed Broker
    02 Housing Information 0296 Statement from Primary Tenant with Telephone Number
    02 Housing Information 7378 Statement from Property Management Company
    02 Housing Information 0332 Statement from Secondary Tenant
    02 Housing Information 1104 Statement from Storage Facility
    02 Housing Information 1108 Statement of Future Plan Moving outside NYC
    02 Housing Information 1124 Statement Referral from Red Cross
    02 Housing Information 5005 Tenant's Request for Inspection
    02 Housing Information 7169 Third Party Proof of Income
    02 Housing Information 1088 Three Estimates from Licensed Movers
    02 Housing Information 1100 Three Itemized Estimates from Contractors
    02 Housing Information 1128 Title to Property
    02 Housing Information 6690 Transmittal HPD or SIP Coordinated Referrals
    02 Housing Information 7439 Verification of program enrollment in a Residential Treatment Center
    02 Housing Information 8206 W-116DD Advantage New York Employment Verification
    02 Housing Information 8207 W-116EE Advantage New York Continuation Appointment
    02 Housing Information 8208 W-116FF Advantage New York Documents Received Letter
    02 Housing Information 8209 W-116GG Important Notice Regarding Your Rental Supplement
    02 Housing Information 8211 W-116KK Advantage New York Documents Incomplete
    02 Housing Information 8212 W-116MM Advantage New York Continuation Decision Notice
    02 Housing Information 8213 W-116PP Advantage Rollover Appointment
    02 Housing Information 8247 W-116RR Advantage Program Continuation Approval Notice
    02 Housing Information 8246 W-116TT Advantage Program Continuation Deferral Notice
    02 Housing Information 8245 W-116UU Advantage Program Continuation Denial Notice
    02 Housing Information 8243 W-116VV Advantage Program Continuation Decision Notice to the Landlord
    02 Housing Information 1334 W-145 Notice of Intent to Restrict Shelter Allowance
    02 Housing Information 1514 W-145A Notice to Landlord-Primary Tenant Rent Restrict Status
    02 Housing Information 1338 W-145AA Notice to Client Determination of Rent Restriction
    02 Housing Information 1342 W-145B Change in Two Party Direct Vendor Rent Payment
    02 Housing Information 1358 W-145J Client's Request for Rent Restriction
    02 Housing Information 1362 W-145JJ Client's Request for change in Rent Payment Method
    02 Housing Information 0992 W-145N Request for Emergency Assistance
    02 Housing Information 1370 W-145P Notice of Acceptance/Denial of Request for Housing Aid
    02 Housing Information 6268 W-146 Landlord Request for Replacement of Direct Vendor Payment
    02 Housing Information 6277 W-146D Agreement by Third Party to Pay Excess Rent
    02 Housing Information 7173 W-146E completed and signed by third party
    02 Housing Information 0316 W-146E Excess Rent & Third Party Proof of Income
    02 Housing Information 6137 W-146F Request for Emergency Housing
    02 Housing Information 5992 W-146R Client request for mailing address change
    02 Housing Information 0312 W-146W Section 8 Verification
    02 Housing Information 6269 W-146Y Direct Vendor Rent Program
    02 Housing Information 6728 W-146Z Certification of Rent Payment
    02 Housing Information 5144 W-147CC Certification of Move Statement
    02 Housing Information 1378 W-147E NYCHA Security Agreement
    02 Housing Information 8025 W-147F Shelter Arrears Repayment Agreement Worksheet
    02 Housing Information 1382 W-147G Repayment Worksheet
    02 Housing Information 1386 W-147H ESNA Shelter Arrears Repayment Agreement
    02 Housing Information 7912 W-147JJ Broker's Statement for Fee Payment by Check
    02 Housing Information 8026 W-147KK EAF Statement of Intent to Repay Excess Shelter Arrears
    02 Housing Information 6661 W-147L Two-Party Check Discrepancy
    02 Housing Information 7911 W-147M Landlord or Managing Agent's Statement
    02 Housing Information 1092 W-147M Landlord's Statement
    02 Housing Information 1518 W-147N Security Deposit Agreement
    02 Housing Information 8327 W-147N-a Security Voucher
    02 Housing Information 8143 W-147NN Information about Repaying the DSS for Utility Arrears
    02 Housing Information 1390 W-147P Broker's Fee Voucher
    02 Housing Information 8144 W-147PP Information about Repaying the DSS for Rental Arrears
    02 Housing Information 0956 W-147Q Statement from Primary Tenant & Proof of Legal Tenancy
    02 Housing Information 6270 W-147V Landlord Agreement
    02 Housing Information 6133 W-147X Utility Arrears Repayment Agreement
    02 Housing Information 5949 W-151A Action taken by Center to prevent eviction-hsing court
    02 Housing Information 1394 W-163 Assignment of Security Deposit
    02 Housing Information 1398 W-163D Acknowledgement of Assignment of Security Deposit
    02 Housing Information 6975 W-166N Verification of ownership of premises
    02 Housing Information 7531 W-25 DHS INS Worksheet
    02 Housing Information 5981 W-30C Change of Address
    02 Housing Information 6432 W-30FF Dwelling Survey Worksheet
    02 Housing Information 8304 W-450Q Landlord Ombudsman Services Unit/Corrective Measures Needed
    02 Housing Information 8303 W-450R Notice of Corrective Measures Taken
    02 Housing Information 7088 W-501B EIHP Participant Statement of Commitment
    02 Housing Information 7087 W-501G Notice of Acceptance for EIHP
    02 Housing Information 7086 W-501P Employment Incentive Housing Program EIHP Lease Rider
    02 Housing Information 8172 W-590BB Compliance with Real Property Assets Unit
    02 Housing Information 8173 W-590DD Failure to Cooperate with Revenue Enforcement Administration
    02 Housing Information 1438 W-637B Request for an Advance to Prevent Eviction
    02 Housing Information 0264 W-700C Verification of Pupil Registration
    02 Housing Information 8161 W-761K Eviction Disposition
    02 Housing Information 7698 W-897H DB Application For Non- Emergency Supportive Housing Form
    02 Housing Information 7145 W-897M Rental Assistance Form I Request to Move to New Residenc
    02 Housing Information 7217 W-897P Notification of Rent Payment Responsibility (RPR)
    02 Housing Information 8314 W-897P Notification Rent Payment Responsibility RPR CSRO-Family
    02 Housing Information 8326 W-902U HRA-NYCHA Housing Referral
    02 Housing Information 8390 W-902W CBCFA REQUEST FOR RECONSIDERATION
    02 Housing Information 6429 W146B Notice Landlord Request for Restricting Rent Payment
    02 Housing Information 8019 Work Advantage Document Packet
    03 Utilities 0376 DSS-3596 Deferred Payment Agreement
    03 Utilities 0352 Electric Bill
    03 Utilities 0392 Fuel Bill Fuel Shut-off Notice
    03 Utilities 0904 Gas & Electric Bill
    03 Utilities 0356 Gas Bill
    03 Utilities 8528 H26HAS-Heap Program Notice of Approval Heater Household
    03 Utilities 7411 H36TDP Home Energy Assistance Program Documentation Requirement
    03 Utilities 7412 H37AP HEAP Program Notice Of Approval
    03 Utilities 7413 H38DN HEAP Program Notice Of Denial
    03 Utilities 7312 Heap 18 Notice Of Home Energy Assistance Program HEAP Benefit
    03 Utilities 6864 HEAP 22 all documents
    03 Utilities 6865 HEAP 23 all documents
    03 Utilities 7313 Heap 26 HEAP Notice of Approval Heater Households
    03 Utilities 7314 Heap 27 HEAP Notice of Approval Heat Included Renter's Benefit
    03 Utilities 7315 Heap 28 HEAP Program Notice of Denial
    03 Utilities 0372 HEAP Information
    03 Utilities 7311 HEAP Program Notice for Heater Households 2009-2010
    03 Utilities 7562 HEAP-11A Request for Energy Fuel Supplier Information for HEAP Grant
    03 Utilities 6727 HEAP-14 Notice of Direct Vendor HEAP Payment
    03 Utilities 6726 HEAP-15 Notice of HEAP Credit to Your Account
    03 Utilities 6576 HEAP-20 all documents
    03 Utilities 6863 HEAP-21 all documents
    03 Utilities 8040 HEAP-40 Cooling Assistance Notice of Eligibility Decision
    03 Utilities 8043 HEAP-41 Clean and Tune Program Notice of Eligibility Decision
    03 Utilities 8174 HEAP-42 Approval Notice
    03 Utilities 8175 HEAP-43 Denial Notice
    03 Utilities 8176 HEAP-44 Applicant Close Case Notice
    03 Utilities 8268 HEAP-6 Heap Program Notice for Heater Household 2010-2011
    03 Utilities 6725 HEAP-8 Notice of HEAP Credit to Your Account with Utility Company
    03 Utilities 0388 Lease Agreement for Water Sewage Garbage
    03 Utilities 7679 M-858 Notice to Utility Company of Direct Vendor Payment
    03 Utilities 1270 M-858c Notice of Intent to Restrict Energy Allowance Timely
    03 Utilities 1498 M-858d Utility Guarantee
    03 Utilities 1506 M-858v Notification to Utility Company
    03 Utilities 1274 M-858w Participant's Request for Utility Restriction
    03 Utilities 1278 M-858x Notice of Intent to Recoup Utility Grant Timely
    03 Utilities 1282 M-858y Request for Utility Grant
    03 Utilities 6678 Notification to Utility Company of Payment or Non-Payment
    03 Utilities 0344 Oil Bill
    03 Utilities 0340 Other Fuel Bill
    03 Utilities 0396 Proof of Air Conditioning Expense
    03 Utilities 0364 Telephone Bill
    03 Utilities 7376 Utilities restore notice
    03 Utilities 5524 Utility Bill
    03 Utilities 8241 Utility Company Statement
    03 Utilities 0952 Utility Company Temporary Shut-off Notice
    03 Utilities 6679 Utility Guarantee code 7 SIC Fair Hearing Update
    03 Utilities 0368 Utility Shut-off Notice
    03 Utilities 6677 Utility Worksheet
    03 Utilities 8027 W-147XX Utility Arrears Repayment Agreement Worksheet
    03 Utilities 6676 W209S IMProject Management Utility Bill Payment Case History
    03 Utilities 0336 Water Bill
    03 Utilities 0380 Water Sewage Bill
    04 Miscellaneous 8011 Affidavits of Mailing
    04 Miscellaneous 7153 AFIS Match Printout No other ID available all other sources exhausted
    04 Miscellaneous 8506 BFI Child Care Documents
    04 Miscellaneous 8508 BFI Civil Litigation Package
    04 Miscellaneous 8491 BFI Historical Records (Prior to 2012)
    04 Miscellaneous 8503 BFI Income/Resources Documents
    04 Miscellaneous 8507 BFI Office of Child Support Enforcement Documents
    04 Miscellaneous 8505 BFI Prescription Drug Fraud Documents
    04 Miscellaneous 8504 BFI Residency Documents
    04 Miscellaneous 8517 BFI-MIIPs Documents
    04 Miscellaneous 7973 Burial Claims Unit Packet
    04 Miscellaneous 7533 CASA archives or back files
    04 Miscellaneous 7377 Document detailing disaster situation
    04 Miscellaneous 8045 Documentation of in-kind hours
    04 Miscellaneous 8159 DSS-3559 Long Term Care Facility Report
    04 Miscellaneous 6580 DSS-4015
    04 Miscellaneous 8594 Easy Image History
    04 Miscellaneous 7184 EIP-ADDEV-1-196 V17 NYC Early Intervention Program Req for Add Eval
    04 Miscellaneous 7005 EXP-76R Documentation Receipt
    04 Miscellaneous 8229 EXP-86H Information About a New Entrance to the Rider Job Center
    04 Miscellaneous 7466 Fair Hearing Packet Default judgments
    04 Miscellaneous 8295 FAX HASA
    04 Miscellaneous 7194 FF-17 Administrative Fraud Hearing Data
    04 Miscellaneous 8888 FHEMS Packet
    04 Miscellaneous 8311 FLY-86 Help is in Your Neighborhood
    04 Miscellaneous 8510 Guardianship paper
    04 Miscellaneous 8861 H-10000 Helper Form
    04 Miscellaneous 7669 HASA Archive
    04 Miscellaneous 8120 Heavy Duty Cleaning Form
    04 Miscellaneous 8091 Homecare Miscellaneous Document
    04 Miscellaneous 7151 LDSS-4733 DFR Legal Residence Statement
    04 Miscellaneous 7570 LDSS-4895 Date Entered Country DEC Data Entry Form Item 347
    04 Miscellaneous 8514 LMD Review W410 & Supporting Docs
    04 Miscellaneous 7406 M-20d HCSP Homemaker Task Plan
    04 Miscellaneous 6933 M-617h Home Visit Checklist of Services
    04 Miscellaneous 6934 M-617j Checklist of Available Services
    04 Miscellaneous 8157 MAP-58u List of Medicaid Offices and Facilitated Enrollers
    04 Miscellaneous 1068 Medical Bills-3 Months Prior to Application
    04 Miscellaneous 7197 NADAP-SACAP Recipient Daily Log
    04 Miscellaneous 0482 Other Proof Unable to Prepare Meals at Home
    04 Miscellaneous 8360 SASC Assessment Confidential Packet
    04 Miscellaneous 8180 TCC-CCSS Child Care MISC
    04 Miscellaneous 0404 Travel Documents
    04 Miscellaneous 5008 Unknown Form
    04 Miscellaneous 8147 Vendor misc document (FOR VENDOR USE ONLY)
    04 Miscellaneous 7405 W-186B Rivera Request Intake Form
    04 Miscellaneous 7925 W-280M RMS 21-Day Call-in Letter
    04 Miscellaneous 7142 W-502B SASC Assessment Interview
    04 Miscellaneous 7141 W-502D Preparation Guide for the SASC Assessment Interview
    04 Miscellaneous 7085 W-561BB Parental Acknowledgment
    04 Miscellaneous 7120 W-585M BEV message center telephone questionnaire
    04 Miscellaneous 7331 W-897 CBO Referral Satisfaction Form
    04 Miscellaneous 5009 WMS Printout MA Pending MA-SSI Budget-WBGTMA and WBGTMB
    05 Absent Parent/LRR 0488 Absent Parent Employment Information
    05 Absent Parent/LRR 0492 Absent Parent Military Prison Institution Information
    05 Absent Parent/LRR 0496 Absent Parent Remarriage Information
    05 Absent Parent/LRR 0484 Absent Parent Spouse Housing Information
    05 Absent Parent/LRR 7174 ACD 1173 Child Care Provider Contact/Emergency Medical Release Form
    05 Absent Parent/LRR 8661 Affidavit of Due Diligence
    05 Absent Parent/LRR 8662 Affidavit of Service by Mail
    05 Absent Parent/LRR 7092 APLR750R 1 Office of child support enforcement referral
    05 Absent Parent/LRR 6722 Child Support Payments Sufficient to met PA Budgetary Needs-Closings
    05 Absent Parent/LRR 7067 CM-179 Affidavit Of Alleged Paternity
    05 Absent Parent/LRR 7074 CM-179c Document or Information Checklist
    05 Absent Parent/LRR 7068 CM-181b Custodial Parent OCSE Interview Sheet
    05 Absent Parent/LRR 7069 CM-181c Guardian or Payee OCSE Interview Sheet
    05 Absent Parent/LRR 5237 CM-182a IS OCSE Information Exchange OCSE Court Unit Report
    05 Absent Parent/LRR 7072 CM-183e Employer Telephone Clearance Form
    05 Absent Parent/LRR 7076 CM-511p CSMS Account Change Request
    05 Absent Parent/LRR 0224 Court Adjudication or Order of Filation
    05 Absent Parent/LRR 0532 Court Alimony Support Papers
    05 Absent Parent/LRR 5010 Court Order of Custody
    05 Absent Parent/LRR 1478 DSS-4281 Attestation to Lack of Information
    05 Absent Parent/LRR 1590 DSS-4281 Attestation to Lack of Information-Spanish
    05 Absent Parent/LRR 0208 DSS-4418 Acknowledgement of Paternity
    05 Absent Parent/LRR 8218 EXP-85XX Request for proof of Bonus Payment Eligibility
    05 Absent Parent/LRR 1040 Form M-384 OCSE Referral
    05 Absent Parent/LRR 7421 Foster Care Checks or Copy of Checks
    05 Absent Parent/LRR 6271 HHC-HS 590 Hospital Statement
    05 Absent Parent/LRR 0536 Hospital Medical Records
    05 Absent Parent/LRR 1624 LDSS-4279 Notice Responsibilities-Rights For Support
    05 Absent Parent/LRR 8660 M-192z Case Control Sheet
    05 Absent Parent/LRR 0504 M-251 Certified Letter
    05 Absent Parent/LRR 7071 M-295 Fee Payment: Documentary Verification of Vital Statistics
    05 Absent Parent/LRR 1494 M-384a Statement of Alleged Paternity
    05 Absent Parent/LRR 0212 M-384b Acknowledgement of Paternity Signed
    05 Absent Parent/LRR 0216 M-384bb Acknowledgement of Paternity
    05 Absent Parent/LRR 1028 M-384d Recertification Absent Parent Questionnaire
    05 Absent Parent/LRR 1024 M-384k M-384m Absent Parent Questionnaire
    05 Absent Parent/LRR 6440 M-384N Letter of Introduction to Bureau of Child Support
    05 Absent Parent/LRR 6156 M-384Q Statement of Alleged Paternity after birth of child
    05 Absent Parent/LRR 7776 M-528m Child Care Guarantee Letter
    05 Absent Parent/LRR 7188 M-528n Request for Child Care Assistance or to Close My PA Case
    05 Absent Parent/LRR 6341 M-804 Summary to Family Court Support Proceedings
    05 Absent Parent/LRR 6272 M-921 Notice of Legal Adoption
    05 Absent Parent/LRR 6273 M-921G Authorization and Approval for Subsidized Adoption
    05 Absent Parent/LRR 5954 M-984d Affidavit alleging paternity
    05 Absent Parent/LRR 6904 Newspaper Notice Death of Parents
    05 Absent Parent/LRR 8408 Non Compliance Letter FTR Court Unit ? FTRCVEN
    05 Absent Parent/LRR 8407 Non Compliance Letter FTR-C Program ? FTRCRT
    05 Absent Parent/LRR 7070 OCSE Establishing Paternity Letter
    05 Absent Parent/LRR 7075 OCSE Letter of Authorization
    05 Absent Parent/LRR 6721 OCSE Referral Work sheet
    05 Absent Parent/LRR 6720 OCSE Support Bonus Payment Worksheet
    05 Absent Parent/LRR 8515 OCSE-179 OCSE Child Support Program Services Informational Flyer
    05 Absent Parent/LRR 8516 OCSE-181 OCSE Customer Services Walk-in Center Referral
    05 Absent Parent/LRR 8598 OCSE-224 OCSE Appointment Reminder
    05 Absent Parent/LRR 0524 Other Acceptable Evidence of Good Cause
    05 Absent Parent/LRR 0220 Other Proof of Acknowledgement
    05 Absent Parent/LRR 0544 Other Proof of Death- Absent Parent or Spouse
    05 Absent Parent/LRR 0508 Other Verification of Absence
    05 Absent Parent/LRR 0520 Police Reports Order of Protection
    05 Absent Parent/LRR 0528 Proof Filed for Alimony Support
    05 Absent Parent/LRR 5744 Registration of Absent or Putative Parents
    05 Absent Parent/LRR 7420 Statement from Foster Care Agency
    05 Absent Parent/LRR 0540 VA-Military Records
    05 Absent Parent/LRR 0500 W-147 Letter to Landlord-Request for Residence Verification
    05 Absent Parent/LRR 6719 W-209W Request for Issuance of Child Support Payments
    05 Absent Parent/LRR 8858 W-273NN Child Care Return Appointment
    05 Absent Parent/LRR 7078 W-273T Child Care Parental Attendance Report
    05 Absent Parent/LRR 7922 W-280J Annual Review Letter PA Case
    05 Absent Parent/LRR 7923 W-280K Annual Review Letter NPA Case
    05 Absent Parent/LRR 7924 W-280L Locate Letter
    05 Absent Parent/LRR 8217 W-351A Request for proof of Bonus Payment Eligibility(CAS)
    05 Absent Parent/LRR 6442 W209X Important Notice Recipients About Child Support Bonus Pay
    06 I/F Stmts 1064 40 Qtrs SSA Clearance-paper For documentation of work history only
    06 I/F Stmts 8148 ACCIS Income Recoupment Packet
    06 I/F Stmts 0744 Adoption Subsidy Benefit Statement
    06 I/F Stmts 0748 Adoption Subsidy Check or Copy
    06 I/F Stmts 0708 Alimony or Support Benefit Statement
    06 I/F Stmts 0704 Alimony or Support Check or Copy
    06 I/F Stmts 0668 Allotment Check or Copy
    06 I/F Stmts 0804 Annuity Statement
    06 I/F Stmts 7435 Appraisal of current value by dealer
    06 I/F Stmts 7434 Appraisal or estimate of current value by broker
    06 I/F Stmts 8534 ARU-SSI Case Packet
    06 I/F Stmts 0416 Automobile Bill of Sale
    06 I/F Stmts 0408 Automobile Estimates-Licensed Dealers 3
    06 I/F Stmts 0432 Automobile Insurance Co. Report Letter
    06 I/F Stmts 0412 Automobile Loan Book
    06 I/F Stmts 0436 Automobile Loan Statement
    06 I/F Stmts 0420 Automobile Registration
    06 I/F Stmts 0424 Automobile Title
    06 I/F Stmts 0604 Bank Account Statement
    06 I/F Stmts 5751 Bank inquiry and clearance Report Agency Completed
    06 I/F Stmts 0596 Bankbook or Passbook
    06 I/F Stmts 8456 BFI-133 Waiver For Financial Inquiry
    06 I/F Stmts 8448 BFI-150 Settlement Agreement
    06 I/F Stmts 8441 BFI-154 Request for City Employment Payroll PMS
    06 I/F Stmts 0760 Brokerage House or Financial Inst statement
    06 I/F Stmts 5523 Budget Entry Supervisory Summary
    06 I/F Stmts 0776 Burial Fund Record
    06 I/F Stmts 0780 Burial Fund Trustee Statement
    06 I/F Stmts 0784 Burial Plot Deed
    06 I/F Stmts 0772 Burial Trust Agreement
    06 I/F Stmts 7463 Cancelled checks or receipts re Other expenses or dependent care cost
    06 I/F Stmts 5012 Change Report Form 2 sheets 4 pages
    06 I/F Stmts 0700 Child Support Benefit Statement
    06 I/F Stmts 0696 Child Support Check or Copy or Money Order or Copy
    06 I/F Stmts 0460 Childcare Provider Letter Receipts
    06 I/F Stmts 7453 Contact with source of unearned income
    06 I/F Stmts 7454 Copy of the court order re: support or childcare or daycare
    06 I/F Stmts 0816 Court Records Trust Trust Fund Settlement Inheritance
    06 I/F Stmts 7525 CS-274W Child Care Provider Enrollment Supplement
    06 I/F Stmts 7301 Current Award Certificate or letter other income
    06 I/F Stmts 7298 Current Award Certificate UIB
    06 I/F Stmts 7300 Current Award Certificate/letter VA Benefits
    06 I/F Stmts 6911 Current Award Letter VA Benefits
    06 I/F Stmts 7459 Current Benefit Check or Copy other income
    06 I/F Stmts 7460 Current Contribution Check
    06 I/F Stmts 7449 Current income tax return
    06 I/F Stmts 0684 Current Receipts for Boarder or Lodger
    06 I/F Stmts 7303 Current wage stubs and Statement of Tips
    06 I/F Stmts 8345 Dept of Treasury Financial Statement
    06 I/F Stmts 0712 Disability Insurance Benefit Statement or Award Notice
    06 I/F Stmts 0636 Dividends Interest Check or Copy
    06 I/F Stmts 0632 Dividends or Interest Statement
    06 I/F Stmts 7464 Documentation of garnishments taken from pay eg pay stub or statement
    06 I/F Stmts 6528 DOH-676 Income and Residency Verification
    06 I/F Stmts 7883 DSP SSI
    06 I/F Stmts 5421 DSS-2521 Application for Child Support Services
    06 I/F Stmts 5015 DSS-3575 PA Single Issuance Authorization Form Payment
    06 I/F Stmts 6253 DSS-3715 EL SSI Benefits Levels
    06 I/F Stmts 6255 DSS-3715EL Supplemental Security Income Benefit Levels
    06 I/F Stmts 5965 DSS-4300 Assignment of Wages Salary other compensation for Services
    06 I/F Stmts 6274 DSS-517 Budget Worksheet-Medical Assistance
    06 I/F Stmts 7433 EITC check or copy
    06 I/F Stmts 7448 Employer letter indicating the number of hours worked and rate of pay
    06 I/F Stmts 8476 FIA-1042-Notice of Employment
    06 I/F Stmts 8179 Financial Management Unit Addendum
    06 I/F Stmts 8712 FMU Client Statements
    06 I/F Stmts 6917 Household Statement of current value
    06 I/F Stmts 0732 HUD Allowance Benefit Statement
    06 I/F Stmts 0736 HUD Allowance Check or Copy
    06 I/F Stmts 0828 In-Trust Account Statement
    06 I/F Stmts 7305 Income tax records
    06 I/F Stmts 6919 Insurance Appraisal
    06 I/F Stmts 0756 Insurance Company Statement
    06 I/F Stmts 7668 IREA L&R Real Property Liens
    06 I/F Stmts 0556 Job Letter
    06 I/F Stmts 6392 Job Notice FIA-3A
    06 I/F Stmts 1736 LDSS-4530 Assignment of Wages Salary Other Compensation for Services
    06 I/F Stmts 0464 Letter from Institution tuition
    06 I/F Stmts 0612 Life Insurance Policy
    06 I/F Stmts 0728 Loan Statement
    06 I/F Stmts 1238 M-15f Agreement to Repay PA
    06 I/F Stmts 1020 M-30t Verification of Unreported Employment
    06 I/F Stmts 6755 M-321j MIS Request for Information About Earned Income
    06 I/F Stmts 7511 M-696f HRA Plan of Self - Support Worksheet
    06 I/F Stmts 6276 MAP 2071A Assignment of Support from Community Spouse
    06 I/F Stmts 5796 MAP-2135A Requirement for a Separate Burial Fund Account
    06 I/F Stmts 7132 Medical bills
    06 I/F Stmts 7455 Medicare deductions
    06 I/F Stmts 0664 Military Allotment Benefit Statement
    06 I/F Stmts 0716 No Fault Insurance Benefit Statement
    06 I/F Stmts 0652 NYS Disability Check or Copy seen
    06 I/F Stmts 0648 NYS Disability Statement
    06 I/F Stmts 7523 OCFS-LDSS-469 Enrollment Form Provider of Legally-Exempt Child Care
    06 I/F Stmts 7524 OCFS-LDSS-4700 Enrollment Provider Legally-Exempt Group Child Care
    06 I/F Stmts 5251 OES-3A Job Notice OES
    06 I/F Stmts 7302 Official correspondence from source of income Other income
    06 I/F Stmts 7408 Official correspondence regarding liens levies and fines
    06 I/F Stmts 0740 Other Document Verifying Past Management
    06 I/F Stmts 0758 Other Income Statement
    06 I/F Stmts 1140 Other Liquid Resource Statement
    06 I/F Stmts 0824 Other Resource Statement
    06 I/F Stmts 6920 Pay Envelope
    06 I/F Stmts 0548 Pay Stubs
    06 I/F Stmts 0428 Police Accident Report & Insurance Letter automobile
    06 I/F Stmts 0452 Police Stolen Car Report & Ins. Co. Letter Report
    06 I/F Stmts 8354 POS Budget Letter for Cash Assistance Case
    06 I/F Stmts 1072 Proof of Income & Resources-3 Months Prior to Application
    06 I/F Stmts 0478 Proof of Medical Expenses
    06 I/F Stmts 0586 Proof of non-applying Step Parent Income and Resources
    06 I/F Stmts 0444 Proof of Non-Ownership automobile
    06 I/F Stmts 8671 Proof of Paid Medical Bills
    06 I/F Stmts 0468 Proof of Payment Legally Obligated Child Support
    06 I/F Stmts 0448 Proof of Repossession automobile
    06 I/F Stmts 7307 Proof of SSA or SSI benefits for disability or blindness
    06 I/F Stmts 0796 Property non-home Deed
    06 I/F Stmts 0792 Property Real Estate Statement
    06 I/F Stmts 7187 Property Tax Statement
    06 I/F Stmts 0564 Quarterly Estimated Tax
    06 I/F Stmts 7634 RAF II - Ongoing & Increase Rent
    06 I/F Stmts 0592 Railroad Benefit Check or Copy
    06 I/F Stmts 0588 Railroad Benefit Letter
    06 I/F Stmts 0692 Receipts from Contributor or Donor
    06 I/F Stmts 0568 Records & Related Mat'l Concerning Earnings & Expenses
    06 I/F Stmts 7304 Records related materials concerning self-employment earnings expenses
    06 I/F Stmts 6240 Report of Student Beneficiary at End of School Year
    06 I/F Stmts 5922 Report of Support Collected
    06 I/F Stmts 0624 Retirement Benefit Letter
    06 I/F Stmts 0628 Retirement Check or Copy
    06 I/F Stmts 5935 Retirement Survivors and Disability Insurance Important Information
    06 I/F Stmts 0594 Room and Board Receipts
    06 I/F Stmts 0590 Sales or Purchasing Agreement
    06 I/F Stmts 6918 Sales Slips
    06 I/F Stmts 0768 Savings Bonds
    06 I/F Stmts 5819 Social Security Administration Supplemental Security Income Notice Pl
    06 I/F Stmts 0600 Social Security Award Letter
    06 I/F Stmts 0584 Social Security Check or Copy
    06 I/F Stmts 0936 SSA 7004-Benefit Estimate Stmt For docum of work history only
    06 I/F Stmts 1178 SSA Benefit Termination Statement
    06 I/F Stmts 0844 SSA Survivor's Benefits Letter for Minor
    06 I/F Stmts 6186 SSA-1 Application for Widow's or Widower's Insurance Benefits
    06 I/F Stmts 6150 SSA-2708 Social Security Administration Important Information
    06 I/F Stmts 7914 SSA-3288 Consent for Release of Information
    06 I/F Stmts 6275 SSA-45 Receipt for Your Claim for S-S Retirement Insurance Benefits
    06 I/F Stmts 6505 SSA-633-U3 Agreement to Refund Overpayment
    06 I/F Stmts 5016 SSA-8000-BK Receipt for Claim of Supplemantal Security Income
    06 I/F Stmts 5898 SSA-8001-ES Receipt for Claim for Supplemental Security Income
    06 I/F Stmts 6151 SSA-8166 Social Security Administration Supplemental Security Income
    06 I/F Stmts 5866 SSA-L1043 Important Information
    06 I/F Stmts 5905 SSA-L634 Social Security Benefit Information
    06 I/F Stmts 5847 SSA-L815 Changes in your Supplemental Security Income Payment Letter
    06 I/F Stmts 5011 SSA-L8151 Change of Payment-SSI Notice of
    06 I/F Stmts 6162 SSA-L8166 Supplemental Security Income Important Information
    06 I/F Stmts 6256 SSA-L8457 SSI Notice of Reconsideration
    06 I/F Stmts 5916 SSA-L991-U3 Why you are not eligible for SSI
    06 I/F Stmts 5907 SSA-SSI Input Information not Eligible for SSI SSA-1991-U3
    06 I/F Stmts 0616 SSI Award Letter
    06 I/F Stmts 0580 SSI Check or Copy
    06 I/F Stmts 8614 SSI/SSDI Supplemented Application
    06 I/F Stmts 1142 Statement detailing circumstances surrounding Loss Theft
    06 I/F Stmts 7451 Statement from Agency Administering Educational Grant or Award
    06 I/F Stmts 7462 Statement from Aide or Attendant re Daycare or Childcare
    06 I/F Stmts 7450 Statement from applicant participant attesting to unverifiable income
    06 I/F Stmts 0812 Statement from Attorney
    06 I/F Stmts 0680 Statement from Boarder or Lodger
    06 I/F Stmts 7299 Statement from Broker or Agent re Interest or Dividends or Royalties
    06 I/F Stmts 0908 Statement from Cemetary or Mortuary
    06 I/F Stmts 0688 Statement from Contributor or Donor
    06 I/F Stmts 7461 Statement from Daycare Center or Other Child Care Provider
    06 I/F Stmts 0928 Statement from Employer
    06 I/F Stmts 0820 Statement from expected Other Income Source
    06 I/F Stmts 7296 Statement from Family Court Child Support
    06 I/F Stmts 0788 Statement from Funeral Director/Funeral Bill
    06 I/F Stmts 0840 Statement from Government Agency paying bill
    06 I/F Stmts 0896 Statement from Joint Owner
    06 I/F Stmts 7429 Statement from Nursing Home
    06 I/F Stmts 7297 Statement from Person Paying Child Support
    06 I/F Stmts 0912 Statement from Person/Group or Organization
    06 I/F Stmts 7436 Statement from source of payment
    06 I/F Stmts 7457 Statement from Source of Payment lump sum
    06 I/F Stmts 7432 Statement from Tax Office
    06 I/F Stmts 0676 Statement of Received Rental Income
    06 I/F Stmts 0608 Statement of Support
    06 I/F Stmts 0832 Statement Sale or Transfer or Created Trust
    06 I/F Stmts 0764 Stock Certificates
    06 I/F Stmts 5017 Summer Child Care Payment Transmittal Form
    06 I/F Stmts 5018 Supplemental payment
    06 I/F Stmts 7428 Support Check Stubs
    06 I/F Stmts 0400 Tax Bill showing ownership of house
    06 I/F Stmts 0560 Tax Return
    06 I/F Stmts 0800 Tax Return Check or Copy
    06 I/F Stmts 8182 TCC-Client Detail Summary For Income Eligibility
    06 I/F Stmts 7598 The Work Number Income Verification Print-Out
    06 I/F Stmts 7444 Transcript or financial aid breakdown
    06 I/F Stmts 0808 Trust Agreement
    06 I/F Stmts 0752 Trust Fund Income Statement
    06 I/F Stmts 0620 UIB Booklet or Printout
    06 I/F Stmts 0572 UIB Check or Copy
    06 I/F Stmts 0576 UIB Statement
    06 I/F Stmts 0724 Union Benefit Check or Copy
    06 I/F Stmts 0720 Union Statement
    06 I/F Stmts 0656 VA Benefit Statement
    06 I/F Stmts 0660 VA Check or Copy
    06 I/F Stmts 7479 VA Spinal Bifida Award Letter or Certificate
    06 I/F Stmts 7481 VA Spinal Bifida Statement
    06 I/F Stmts 1136 Verification Income Resources Stopped Exhausted
    06 I/F Stmts 6573 W-112E Wage Reporting Clearance
    06 I/F Stmts 1510 W-122D FS Budget Worksheet PA
    06 I/F Stmts 1294 W-122DD FS Budget Worksheet PA-SSI-Aged Disabled
    06 I/F Stmts 6350 W-128HH Notice to Recipients SSI Check Retro Benefit Calc
    06 I/F Stmts 5859 W-138 Employment Earnings Questionnaire
    06 I/F Stmts 1318 W-140B SSI Family PA Calculation NON-ISAS Unit
    06 I/F Stmts 1322 W-140C Non-SSI Family PA Calculation NON-ISAS Unit
    06 I/F Stmts 1326 W-140D SSI Single Person PA Calculation NON-ISAS Unit
    06 I/F Stmts 1682 W-140DD New Claim Calculation Worksheet
    06 I/F Stmts 1330 W-140E Enhance Rent Calculation Worksheet
    06 I/F Stmts 1676 W-140K Expedited Service Worksheet
    06 I/F Stmts 1680 W-140M Discrepant Eligibility Information Tracking Form
    06 I/F Stmts 6278 W-163A Agreement to Repay Safety Net Assistance Still Owed
    06 I/F Stmts 7216 W-2 Form
    06 I/F Stmts 6238 W-2-496 Real Property & Asset Section Transmittal Sheet
    06 I/F Stmts 5985 W-205A Checks Receipt
    06 I/F Stmts 5013 W-232 SP Check Copy-Payment to Daycare Provider
    06 I/F Stmts 0456 W-273B Childcare Provider Form
    06 I/F Stmts 5160 W-273B S Childcare Provider Form Spanish
    06 I/F Stmts 7379 W-274U Attestation of Employment: Informal Child Care Provider
    06 I/F Stmts 7380 W-274UU Income Verification for Child Care Provider Letter
    06 I/F Stmts 1000 W-451 NYPD-Job Center Report/Referral
    06 I/F Stmts 7920 W-475A DARBIDUN
    06 I/F Stmts 7921 W-493A DARBIDUN
    06 I/F Stmts 7913 W-500QQ TALX The Work Number Express Services Data Sheet
    06 I/F Stmts 7595 W-501K EIHP Monthly Household Income Contribution Worksheet
    06 I/F Stmts 0996 W-532 Letter to Past/Present Employer
    06 I/F Stmts 1004 W-532f Financial Institution Inquiry
    06 I/F Stmts 5014 W-574DD Client Change Form
    06 I/F Stmts 6816 W-575T Declaration of Employment
    06 I/F Stmts 6657 W-587G Real Property and Assets Inquiries
    06 I/F Stmts 7696 W-592R Employment Income Questionnaire Letters
    06 I/F Stmts 6027 W-638A Financial Inquiry
    06 I/F Stmts 1442 W-648 Family Budget Calculation
    06 I/F Stmts 6662 W-648A Step-Parent Income Budget Worksheet
    06 I/F Stmts 6815 W-648B Alien Sponsor or Step-Parent Budget Worksheet
    06 I/F Stmts 8230 W-648J Congregate Care Budget Worksheet
    06 I/F Stmts 8262 W-648K Income Saving Requirement Worksheet
    06 I/F Stmts 8263 W-648M Temporary Housing Budget Worksheet
    06 I/F Stmts 0672 W-700V Educational Grants or Loans
    06 I/F Stmts 7919 W-820 DARBIDUN
    06 I/F Stmts 7917 W-820A DARRECPT
    06 I/F Stmts 7918 W-820B DARRECPT
    06 I/F Stmts 7615 W34A Clothing Grants-CBCFA
    06 I/F Stmts 7285 WINRO027 PA or FS Budget Summary
    06 I/F Stmts 6624 Worker's Compensation WCB New Claim - Bi weekly payment status
    06 I/F Stmts 6625 Worker's Compensation WCB New Claim - Bi weekly status
    06 I/F Stmts 0640 Workers' Compensation Board Statement or Award letter
    06 I/F Stmts 0644 Workers' Compensation Check or Copy
    06 I/F Stmts 5996 WR2 Concealed Income Worksheet
    07 Corsp/Notices 7243 ACD-1061 ACD - Notice of Rejection of Day Care Application
    07 Corsp/Notices 5024 Advance Notice of Your Administrative Disqualification Hearing 3 pages
    07 Corsp/Notices 8184 APL320 Case Closure Warning- Location Services Child Support
    07 Corsp/Notices 8185 APL325 Case Closure Warning- Support Order Must be Filed
    07 Corsp/Notices 8186 APL330 Case Closure Warning- No Child Support Order Entered
    07 Corsp/Notices 8187 APL335 Case Closure Warning- Interstate Packet Needed
    07 Corsp/Notices 5027 Appointment Letter any kind
    07 Corsp/Notices 8003 APS FMU Client Statements
    07 Corsp/Notices 8139 APS Referral Letter
    07 Corsp/Notices 8437 BFI-155 Photo Array Form
    07 Corsp/Notices 8439 BFI-164 Prescription Receipt
    07 Corsp/Notices 7155 BFI-25 BFI Appointment Letter
    07 Corsp/Notices 8422 BFI-31 Address information request
    07 Corsp/Notices 7156 BFI-36 BFI Letter to Landlord re Household Presence or Composition
    07 Corsp/Notices 8438 BFI-39 Photo ID for Employment Verification
    07 Corsp/Notices 7094 BFI-44 Voluntary Statement
    07 Corsp/Notices 8467 BFI-Allegation
    07 Corsp/Notices 8466 BFI-DA Package
    07 Corsp/Notices 8463 BFI-Doctor Statements
    07 Corsp/Notices 8464 BFI-Food Stamp Claim Package
    07 Corsp/Notices 8465 BFI-IPV Package
    07 Corsp/Notices 8317 CAS-101 Authorization for Release of Health Info Pursuant to HIPAA
    07 Corsp/Notices 8359 CAS-202 DSP Request for Additional Information
    07 Corsp/Notices 8844 CAS-203 Notification to SSA Change of Authorized Representative Status
    07 Corsp/Notices 8845 CAS-204 Disability Services Program Hearing Preparation Notification
    07 Corsp/Notices 8846 CAS-207 Disability Services Program Authorized Representative
    07 Corsp/Notices 8847 CAS-208 Disability Services Program Appeal Assessment Appointment
    07 Corsp/Notices 8848 CAS-209 Disability Services Program Assessment Interview
    07 Corsp/Notices 8344 CAS-300 Home Visit/HB WeCare appointment
    07 Corsp/Notices 8064 Case Management Notes
    07 Corsp/Notices 8642 CC-114 IREA Div of Claims Letter to Sponsor
    07 Corsp/Notices 5755 Certification of Title IV E ADC-FC Categorical and Financial Eligib
    07 Corsp/Notices 6176 Certified Mail Receipt
    07 Corsp/Notices 7032 CM-174 First Contact Letter OCSE
    07 Corsp/Notices 7033 CM-174a Second Contact Letter OCSE
    07 Corsp/Notices 8121 Consent for the release of confidential alcohol or drug treatment
    07 Corsp/Notices 7676 Consumer or Client handwritten or typed letter any kind
    07 Corsp/Notices 8744 CSET-Assignor Notice
    07 Corsp/Notices 5029 Denial Notice of
    07 Corsp/Notices 7038 DFRP Closing Letter OCSE Child Support Greater Than PA Needs
    07 Corsp/Notices 7027 DHS-309 Att. to Applicants Emerg. Housing Serv w pend elig
    07 Corsp/Notices 5030 Documentation Return Letter
    07 Corsp/Notices 7878 DSP Appointment Letter
    07 Corsp/Notices 6102 DSS-109 Notification of action taken - termination of benefits
    07 Corsp/Notices 7007 DSS-3156 Notice Of FS Overpayment Demand Letter replaces EXP-36H
    07 Corsp/Notices 6279 DSS-3340 Change Appellant Information Form
    07 Corsp/Notices 6928 DSS-3622 Notice of Decision on Your Medicaid Application
    07 Corsp/Notices 6280 DSS-3623 Notice of Intent to Discontinue or Change Medical Assistance
    07 Corsp/Notices 5895 DSS-3631 Personal Privacy Protection Law Notification to Clients
    07 Corsp/Notices 6183 DSS-3792 Aid to Continue Directive
    07 Corsp/Notices 6543 DSS-4022 Notice of Intent to Establish Liability Toward Chronic Care
    07 Corsp/Notices 6206 DSS-4218 Fair Hearing Request Form-Fax or Mail
    07 Corsp/Notices 5026 DSS-4220 Notice to Appellant Spanish version
    07 Corsp/Notices 6552 DSS-4231 Option to End Your Sanction
    07 Corsp/Notices 6260 DSS-L-3926-EP Your Benefits Will Continue in the Same Amount
    07 Corsp/Notices 6447 DSS4482/20 Transmittal Of Fair Hearing Decision to Representative
    07 Corsp/Notices 1620 EBT-23 Notice of Special PA or FS Benefits
    07 Corsp/Notices 7084 EBT-23 S Notice of Special PA/FS Benefits Spanish
    07 Corsp/Notices 8829 EBT-53 Pin Pad Password Request
    07 Corsp/Notices 8830 EBT-56 Administrative Terminal Password Request
    07 Corsp/Notices 8831 EBT-59 Common Benefit Identification Card
    07 Corsp/Notices 5031 Eligibility Denial or Ending Status Notice of
    07 Corsp/Notices 8049 EXP-76CC Homebound Review Project Mail Return
    07 Corsp/Notices 8050 EXP-76DD Homebound Review Project General Telephone Log
    07 Corsp/Notices 7008 EXP-76K Recertification Update Notice
    07 Corsp/Notices 7009 EXP-76K S Recertification Update Notice Spanish
    07 Corsp/Notices 7686 EXP-78PP Intensive Services Center Letter
    07 Corsp/Notices 7371 EXP-78QQ Family Services Call Center Documentation Request
    07 Corsp/Notices 7555 EXP-83C Job Fair Notice
    07 Corsp/Notices 7856 EXP-83X MKB Retroactive Relief Worksheet
    07 Corsp/Notices 7688 EXP-84 Outreach Letter
    07 Corsp/Notices 7943 EXP-84DD Job Fair Notice
    07 Corsp/Notices 7952 EXP-84FF Homebound Review Project/Notice of Decision
    07 Corsp/Notices 7953 EXP-84GG You May Be Owed Money By the City of New York
    07 Corsp/Notices 7954 EXP-84HH Homebound Review Project/Decision/Your Request for a Review
    07 Corsp/Notices 7955 EXP-84JJ Homebound Review Project/Outreach Return Form
    07 Corsp/Notices 8051 EXP-84KK Remove Homebound Status Request Form
    07 Corsp/Notices 7855 EXP-84M Child Support Voluntary Appointment Notice
    07 Corsp/Notices 8053 EXP-84QQ Request for a Homebound Application Interview
    07 Corsp/Notices 8052 EXP-84RR Homebound Review Project Eligible for Retroactive Medicaid
    07 Corsp/Notices 7854 EXP-84T Notice of Overpayment
    07 Corsp/Notices 8054 EXP-84WW Notice of Outcome of Your Case Review
    07 Corsp/Notices 8055 EXP-84XX Acknowledgement of Telephone Request for a Case Review
    07 Corsp/Notices 7978 EXP-85C Appointment Notice
    07 Corsp/Notices 8125 EXP-85W Notice of Job Preparation Day
    07 Corsp/Notices 5032 Expiration of Food Stamp Benefits and Recertification Notice of
    07 Corsp/Notices 7979 FCP405L1 Intent To Close Letter
    07 Corsp/Notices 7980 FCP405L1D Intent To Close Deceased Respondent Letter
    07 Corsp/Notices 8823 FIA-1026b Appointment Notice Child Care in Lieu of Cash Assistance
    07 Corsp/Notices 8824 FIA-1026c Rescheduled Appointment for Child Care Cash Assistance
    07 Corsp/Notices 8310 FIA-1028 Home Visits Needed/Homebound Determination Process
    07 Corsp/Notices 8321 FIA-1028d Request to Remove Home Visit Needed/Homebound Status
    07 Corsp/Notices 8322 FIA-1028e Notice of Removal of Home Visit Needed/Homebound Status
    07 Corsp/Notices 8682 FIA-1077 Hercules Settlement Payment
    07 Corsp/Notices 8825 FIA-1093 Child Care Cash Assistance Recertification Appointment
    07 Corsp/Notices 8805 FIA-1094 Comprehensive Letter
    07 Corsp/Notices 8819 FIA-1094b Important Notice Regarding Your Recertification Appointment
    07 Corsp/Notices 8820 FIA-1094c Notice Regarding Your SNAP Application
    07 Corsp/Notices 8821 FIA-1094d Batch Cancellation Notice
    07 Corsp/Notices 8822 FIA-1094e Notice of Removal of Recoupment
    07 Corsp/Notices 8826 FIA-1094h Recoupment Transfer Notice
    07 Corsp/Notices 8827 FIA-1094i Recoupment Transfer and Refund Notice
    07 Corsp/Notices 8841 FIA-1094m Regarding the Hercules Notice You Recently Received
    07 Corsp/Notices 8842 FIA-1094n Hercules Notice You Recently Received March 20, 2013
    07 Corsp/Notices 8807 FIA-1095 Able Bodied Adults Without Dependents (WEP) Assignment Letter
    07 Corsp/Notices 8811 FIA1094a Supplemental Nutrition Assistance Recertification Appointment
    07 Corsp/Notices 7944 HEAPHA29 SUA1 Notice of Home Energy Assistance Program Grant
    07 Corsp/Notices 5034 Information and or Documentation Request for
    07 Corsp/Notices 5037 Intentional Program Violation Disqualification Notice for PA and FS Benefits
    07 Corsp/Notices 7963 IREA C&C REFERRALS
    07 Corsp/Notices 8813 LDSS 4779 Approval of Your Application for Child Care Benefits
    07 Corsp/Notices 8814 LDSS 4780 Denial of Your Application for Child Care Benefits
    07 Corsp/Notices 7583 LDSS-4005 NYC Notice of Temp or Asst Work Require Determin or Exempt
    07 Corsp/Notices 7584 LDSS-4005a NYC Notice of Temp or Asst Work Require Deter-Non-Exempt
    07 Corsp/Notices 6962 LDSS-4013A NYC Action Taken On Your Application PA FS and MA
    07 Corsp/Notices 6963 LDSS-4013B NYC Action Taken On Your Application PA FS and MA
    07 Corsp/Notices 6964 LDSS-4014A NYC Action Taken On Your Recert PA FS MA
    07 Corsp/Notices 6965 LDSS-4014B NYC Action Taken On Your Recert PA FS MA
    07 Corsp/Notices 6966 LDSS-4015A NYC Notice of Intent To Change Benefits PA FS MA
    07 Corsp/Notices 6967 LDSS-4015B NYC Notice of Intent To Change Benefits PA FS MA
    07 Corsp/Notices 6968 LDSS-4016A NYC Notice of Intent To Change Benefits PA FS MA
    07 Corsp/Notices 6969 LDSS-4016B NYC Notice of Intent To Change Benefits PA FS MA
    07 Corsp/Notices 7961 LDSS-4776 Safety Net Assistance Application Supplement
    07 Corsp/Notices 1698 Letter From Supervising Adult in Household
    07 Corsp/Notices 6542 M-11J Notice of Decision to Provide Home Care Services
    07 Corsp/Notices 6796 M-186hh Notice of Mandatory Dispute Resolution Notice of Intent
    07 Corsp/Notices 1718 M-186JJ Notice of Mandatory Dispute Resolution NOI
    07 Corsp/Notices 6797 M-186rr Mandatory Dispute Resolution Action Taken Form
    07 Corsp/Notices 6078 M-255B Notice of Case Transfer
    07 Corsp/Notices 1222 M-3 Action Taken on Your Application:PA-MA-FS
    07 Corsp/Notices 1246 M-31g Notice to report to Social Security Office
    07 Corsp/Notices 6758 M-321 Recertification Appointment Job Center
    07 Corsp/Notices 6754 M-321k Food Stamp Recertification Notice
    07 Corsp/Notices 6283 M-322F LDSS-4594 Decision Notice: Waiver Temp Delay PA Require
    07 Corsp/Notices 1742 M-327f Time Limit Reassessment Interview
    07 Corsp/Notices 8012 M-327h Mail-In Recertification/Eligibility Questionnaire
    07 Corsp/Notices 6092 M-328A Notice of Intent to Reduce Public Assistance
    07 Corsp/Notices 8204 M-328AA Notices for Recoupment Transfers
    07 Corsp/Notices 6079 M-328B Notice of Change in Grant
    07 Corsp/Notices 6080 M-328H Notice of Change in Grant
    07 Corsp/Notices 6093 M-328N Notice of Intent to Reduce Public Assistance
    07 Corsp/Notices 6096 M-33A Notice Regarding Lump Sum Payment
    07 Corsp/Notices 6284 M-3a Notice of Reduction of Public Assistance and/or FS Benefits due
    07 Corsp/Notices 6285 M-3b Understanding of Documentation Requirements
    07 Corsp/Notices 1226 M-3c-a Notice of Intent to Change Continue Benefits
    07 Corsp/Notices 5036 M-3c-b Intent to Discontinue PA-FS-MA Benefits Notice of
    07 Corsp/Notices 1250 M-3e Clients Acknowledgement of change in benefits
    07 Corsp/Notices 6544 M-3f Notice of Non-Acceptance
    07 Corsp/Notices 1254 M-3g Notice to Report to Center
    07 Corsp/Notices 1644 M-3mm Notification of Application Withdrawal
    07 Corsp/Notices 6184 M-40k Notice of Denial of Expedited FS or Inability to Issue FS
    07 Corsp/Notices 5081 M-42e Notice Concerning Your Medicaid Application
    07 Corsp/Notices 6081 M-55 Notice of Change of Center
    07 Corsp/Notices 1752 M-687k Safety Net Assistance Application Interview
    07 Corsp/Notices 8333 M-74 Application to The Residential Treatment Service Center (RTSC)
    07 Corsp/Notices 6788 M-74e NYCWAY Mandatory Appointment Letter
    07 Corsp/Notices 6789 M-74f NYCWAY Appointment Letter-Voluntary
    07 Corsp/Notices 6045 M-75b Important Notice Request for medical examination
    07 Corsp/Notices 7232 M-75bb Substance Abuse Initial Appointment
    07 Corsp/Notices 1710 M-75g Consent for Disclosure of MAP Records ASA Treatment
    07 Corsp/Notices 6660 M-858ff Notice of Intent to Restrict Home Energy Allowance
    07 Corsp/Notices 5466 M-927 Loss of Eligibility for TITLE IVE ADC-FC Assistance Notice of
    07 Corsp/Notices 6261 M5A Notice of Expiration of Food Stamps Benefits
    07 Corsp/Notices 5442 MAP 2087A Denial of Your Medical Assistance Application Notice of
    07 Corsp/Notices 5419 MAP 2087U Action Notice: App for MA Buy-In Prgrm MAP-258K replaces
    07 Corsp/Notices 5435 MAP Continuation of Your Medicaid Eligibility Recertification
    07 Corsp/Notices 7847 MAP- 909H DAB-Managed Long Term Care Renewal Notification
    07 Corsp/Notices 7851 MAP- 931U Excess Income Program/Family Health Plus Selection Letter
    07 Corsp/Notices 6204 MAP- Facts Sheet For Submission of Documentation for Reimburs
    07 Corsp/Notices 5457 MAP-153A Notice to Hospital of Patient Ineligibility Code 2
    07 Corsp/Notices 6225 MAP-2 Notice of Acceptance of Your MA Appt w Limited Coverage
    07 Corsp/Notices 6289 MAP-2001Notice of Acceptance of Your Medicaid Application Pregnancy
    07 Corsp/Notices 6290 Map-2006 Notice of Eligibility for Medical Assistance
    07 Corsp/Notices 6291 MAP-2010F Notice of Denial on Your Nursing Home Conversion Request
    07 Corsp/Notices 5422 MAP-2016B Appointment Notice of
    07 Corsp/Notices 5495 MAP-2025 Recertification Appointment, Notice of
    07 Corsp/Notices 7144 MAP-202B Important Notice to Food Stamp Recipient /former MAP-2002B
    07 Corsp/Notices 6888 MAP-2033E Notice of Retroactive Eligibility (Fair Hearing)
    07 Corsp/Notices 5459 MAP-2052A Inability to Process Referral Notice of
    07 Corsp/Notices 6947 MAP-2067A Notice Of Use Of Old Excess Income Amount-Home Care
    07 Corsp/Notices 6948 MAP-2070M Notice Of Intent Change Contribution To Chronic Care Costs
    07 Corsp/Notices 6893 MAP-2070V Notice to Community Spouse re Income
    07 Corsp/Notices 6784 MAP-2083G Notice of Decision on Reimbursement of Medical Bills
    07 Corsp/Notices 5436 MAP-2087 Decision of Your Medical Assistance Application Notice of
    07 Corsp/Notices 5928 MAP-2087D Decision to Terminate your MA FT Return FFR Statement
    07 Corsp/Notices 5458 MAP-2087F Notice of Decision MA Application MA FHP FPBP Denial
    07 Corsp/Notices 5929 MAP-2087H MA Discontinue Notice Child 6-18 was Eligible at 133 percent
    07 Corsp/Notices 5418 MAP-2087K Acceptance of Your MA Application Institutional Services
    07 Corsp/Notices 5793 MAP-2087M Notice of Intent to Change Amount Your Net Available Mo.
    07 Corsp/Notices 7177 MAP-2087N Notice Of Acceptance Of Your MA Application (RVI)
    07 Corsp/Notices 7176 MAP-2087P Notice Of Increase To Your MA Eligibility Level (RVI)
    07 Corsp/Notices 7178 MAP-2087Q Notice Of Decrease To Your MA Eligibility Level (RVI)
    07 Corsp/Notices 5930 MAP-2087R Intent to Discontinue Medical Assistance Notice of
    07 Corsp/Notices 6945 MAP-2087U Action Notice: App for MA Buy-In Prgrm MAP-258K replaces
    07 Corsp/Notices 5417 MAP-2088H Acceptance of Your Medicaid Application Pregnancy Notice
    07 Corsp/Notices 5521 MAP-2088J Notice of Your MA Recertification Eligibility Decision
    07 Corsp/Notices 6929 MAP-2088M Notice of Accept. MA with Limited Cov. (Spousal Refusal)
    07 Corsp/Notices 5479 MAP-2088U Medical Assistance Disability Determination Notice of
    07 Corsp/Notices 6896 MAP-2088Y Notice of Decision on your MA Application Full Coverage
    07 Corsp/Notices 6924 MAP-2089D Notice Concerning Your Zero NAMI Request
    07 Corsp/Notices 6925 MAP-2089E Notice of Acceptance - Medicaid Application
    07 Corsp/Notices 5795 MAP-2094V Request to get notices in English/Spanish or English Only
    07 Corsp/Notices 6765 MAP-2097B Notice Change Full MA Coverage to FHP FNP Parent
    07 Corsp/Notices 6766 MAP-2097C Notice: Change Full MA Coverage 2 FHP Spenddown-Elig or FP
    07 Corsp/Notices 6767 MAP-2097D Notice Change Full MA Coverage to FHP SCC-100 percent
    07 Corsp/Notices 6768 MAP-2097E Notice of Change -turning 19 MA to Family Health Plus
    07 Corsp/Notices 6769 MAP-2097F Notice of Change from Family Health Plus to MA
    07 Corsp/Notices 6770 MAP-2097G Notice to Remain in Family Health Plus
    07 Corsp/Notices 6772 MAP-2097H Notice of Change from Full MA to Excess Income
    07 Corsp/Notices 6774 MAP-2097M Notice of Denial of Your Family Health Plus Application
    07 Corsp/Notices 6775 MAP-2097N Notice of Denial of Your Family Health Plus Application
    07 Corsp/Notices 6747 MAP-2097P Notice of Denial of Fam Health Plus
    07 Corsp/Notices 6777 MAP-2097Q Notice of FHP Acceptance of Health Insurance Application
    07 Corsp/Notices 6778 MAP-2097R Notice of FHP Acceptance of Health Insurance Application
    07 Corsp/Notices 6780 MAP-2097U Notice of FHP Acceptance of Health Insurance Application
    07 Corsp/Notices 5433 MAP-2100C Conference Review Results Notice of
    07 Corsp/Notices 5452 MAP-2120B Eligibility for Medical Assistance Home Care Serv Notice of
    07 Corsp/Notices 5451 MAP-2151B Notice Of Decision Regarding Your Emergency MA Coverage
    07 Corsp/Notices 5486 MAP-2158D Notice to MA BuyIn Appl W Xcess Income MAP-258D replaces
    07 Corsp/Notices 6946 MAP-2158K Action Notice: MA Premium Pymnt Prgrm MAP-258K replaces
    07 Corsp/Notices 5485 MAP-2161B Notice to a Legally Respon Relative of a Medicaid Recipient
    07 Corsp/Notices 5456 MAP-2985 Hospital of Medicaid Decision Notification to
    07 Corsp/Notices 8487 MAP-316M Notice of Home Health Agency of AID Continuing Directive
    07 Corsp/Notices 7934 MAP-480M Notice of Disenrollment From A Medicaid Managed Care Plan
    07 Corsp/Notices 6921 MAP-635A Mail Renewal Notice/CHP B Referral
    07 Corsp/Notices 8156 MAP-635R Return of Late Mail Renewal Application
    07 Corsp/Notices 7848 MAP-648Z Relocation Referral Transmittal
    07 Corsp/Notices 7933 MAP-751R Request to Update Address information on file
    07 Corsp/Notices 7931 MAP-751T Verification of New Address or Request to Close Case
    07 Corsp/Notices 5517 MAP-992A Excess Income Program Decision Notice
    07 Corsp/Notices 6198 MAP/E C909 Dear Former SSI Beneficiary
    07 Corsp/Notices 6312 MAP/E L631 Notice of Auth Participation in Long Term Health Care
    07 Corsp/Notices 6259 MAP/EC1249 You did not include the following information
    07 Corsp/Notices 6227 MAP2067 Notice of Continued Use of Prior Excess Income
    07 Corsp/Notices 6293 MEP-2155D Denial of Request for Reimbursement of pd med bills
    07 Corsp/Notices 6294 MEP-992 Acknowledgement of Inquiry
    07 Corsp/Notices 5483 Miscellaneous Notice
    07 Corsp/Notices 7857 MKB-83W MKB Request for Case Review
    07 Corsp/Notices 5038 Notice of Intent to Change or Continue any kind
    07 Corsp/Notices 5039 Notice of Intent to Discontinue any kind
    07 Corsp/Notices 6319 Notice of Intent to Suspend Child Care Allowance
    07 Corsp/Notices 6642 Notice of Issuance of Advance to Prevent Eviction & Int to Rest Shel
    07 Corsp/Notices 6603 Notice of Reduction of PA.& or FS benefits due to receipt of SSI
    07 Corsp/Notices 7885 OCSE Appointment Notice
    07 Corsp/Notices 7039 OCSE CSET Assignor Notice regards petition court date
    07 Corsp/Notices 7040 OCSE Letter Notice To Report To Family Court
    07 Corsp/Notices 8748 OCSE-189 Restraining Notice
    07 Corsp/Notices 6910 Official Correspondence from Social Security Administration
    07 Corsp/Notices 6908 Official Correspondence from the Child Support Enforcement Unit
    07 Corsp/Notices 6909 Official Correspondence from the New York State Department of Labor
    07 Corsp/Notices 7089 RA-3310 Owner's Report Cert or Notice of Fuel Cost Adjust Elig
    07 Corsp/Notices 7098 RED-12 Face to face recert appointment notice Tier II shelter
    07 Corsp/Notices 6670 RED-2 Home Visit Appointment Deferred Recertification
    07 Corsp/Notices 5042 Reinstatement Notice of
    07 Corsp/Notices 5510 Required Corrective Action on State Quality Control FindingsNotification of
    07 Corsp/Notices 6247 Rescheduled Appointment
    07 Corsp/Notices 5044 Rescheduling Letter
    07 Corsp/Notices 8220 RTSC NYCWAY-CASAC Code Information
    07 Corsp/Notices 7902 SSA Notice of Decision Unfavorable HA-L76-OP2
    07 Corsp/Notices 7901 SSA Notice of Hearing HA-L83
    07 Corsp/Notices 5838 SSA-11BK A Reminder to Payee Applicants
    07 Corsp/Notices 6200 SSA-1207 Disability Hearing Officer's Decision
    07 Corsp/Notices 6182 SSA-135-EP Advanced Notice of Termination of Childs Benefits
    07 Corsp/Notices 6242 SSA-2118 u2 Request for Documents or Information
    07 Corsp/Notices 6345 SSA-5002 Report of Contact
    07 Corsp/Notices 6199 SSA-53-EP Did You Forget Recouping overpaid SSI Benefits
    07 Corsp/Notices 6545 SSA-53-EP Notice of Payment Due
    07 Corsp/Notices 5023 SSA-800B Additional information about your claim
    07 Corsp/Notices 6296 SSA-8203-BK Your Reporting Responsibilities
    07 Corsp/Notices 6297 SSA-L305 Record of Conversation
    07 Corsp/Notices 6298 SSA-L4201 Request for Information About Wages
    07 Corsp/Notices 7798 SSA-L442 Notice of Disapproved Claim SSDI
    07 Corsp/Notices 7154 SSA-L676 SSN Card Denial Notice
    07 Corsp/Notices 6161 SSA-L8030 Supplemental Security Income - Notice of Disapproved Claim
    07 Corsp/Notices 6044 SSA-L8165 Important Notice - New SSI Rules on Eligibility
    07 Corsp/Notices 6231 SSA-L8171-U-3 Notice of Overpayment
    07 Corsp/Notices 7417 SSI Appeal Letter
    07 Corsp/Notices 7416 SSI Denial Letter
    07 Corsp/Notices 6915 Statement from Provider of Coverage Health Insurance
    07 Corsp/Notices 6295 Supplement to Claim of Person Outside the United States
    07 Corsp/Notices 8081 Treating Physician's Wellness Plan Report
    07 Corsp/Notices 7407 Vendor Client case notes letters notices forms for PRIDE client
    07 Corsp/Notices 5799 Verification of School Attendance
    07 Corsp/Notices 6912 Veteran's Administration's Official Correspondence
    07 Corsp/Notices 1656 W-102 Notification to Participant of New Worker
    07 Corsp/Notices 7546 W-103D Special Assessment Letter
    07 Corsp/Notices 6082 W-106E Notice of Decision on Returned Check
    07 Corsp/Notices 6793 W-113A Documentation Request Form-for Additional Allowances
    07 Corsp/Notices 1290 W-113K Documentation Required
    07 Corsp/Notices 7010 W-113K S Documentation Requirements Spanish
    07 Corsp/Notices 6952 W-116 S Notice of Approval Request Educat or Training Spanish
    07 Corsp/Notices 6745 W-116G Notice of Job Interview
    07 Corsp/Notices 6951 W-116J Notice of Approval Request Educational or Training Program
    07 Corsp/Notices 6953 W-116R Notice of Denial Request Educational or Training Program
    07 Corsp/Notices 6954 W-116R S Notice of Denial Request Educat or Training Spanish
    07 Corsp/Notices 7011 W-116T Notice of Training Alternative Program
    07 Corsp/Notices 7012 W-116T S Notice of Training Alternative Program Spanish
    07 Corsp/Notices 7019 W-119 Request for Contact on a Mailed Faxed Application
    07 Corsp/Notices 6791 W-120K Food Stamps- Request for Contact or Missed Interview
    07 Corsp/Notices 7942 W-126E Food Stamp Telephone Recertification Reminder Notice
    07 Corsp/Notices 6091 W-129EE Notice of Intent to Reduce Food Stamp Benefits
    07 Corsp/Notices 6730 W-129S Notice of Intent to Discontinue Food Stamps Benefits 4sides
    07 Corsp/Notices 6299 W-130H Notice of Forwarding of Application
    07 Corsp/Notices 6075 W-130Y Notice of Adverse Action - Reduc of Allot Recover Overissuance
    07 Corsp/Notices 8227 W-131WW Notice of Able Bodied Adult without Dependents Status
    07 Corsp/Notices 1648 W-132EE Notice of Transfer of Food Stamp Case
    07 Corsp/Notices 6300 W-132S Documentation Required-Changes in Household Circumstances
    07 Corsp/Notices 6303 W-133 Notice of Expiration of FS Benefits SSI or Homebound Recipients
    07 Corsp/Notices 6301 W-133U Notification of Forwarding of FS Application to Another Office
    07 Corsp/Notices 6302 W-133V Notice of Recertification
    07 Corsp/Notices 7102 W-134A Demand Letter for Over issuance
    07 Corsp/Notices 7140 W-134N Food Stamp Claims Acknowledgement Of Payment Received
    07 Corsp/Notices 5045 W-134R We received your recent correspondence
    07 Corsp/Notices 1298 W-137A Request for Additional Allowance
    07 Corsp/Notices 1306 W-137B Acceptance-Denial of Request for Additional Allowance
    07 Corsp/Notices 8297 W-137G Notice of Additional Food Stamps
    07 Corsp/Notices 8337 W-137H Outcome of Review for Restored Food Stamp Benefits
    07 Corsp/Notices 8298 W-137K Food Stamp Outreach Notice
    07 Corsp/Notices 6304 W-138AA Application for Food Stamp Benefits Can Be Processed
    07 Corsp/Notices 6305 W-138B Informational Notice to Able-Bodied FS Work Restraints
    07 Corsp/Notices 6658 W-138D Notification of Work Requirements & Right to Contest or FS
    07 Corsp/Notices 6639 W-138E Call-In Letter for an ABAWD
    07 Corsp/Notices 7013 W-138E S Call-In Letter for ABAWD Spanish
    07 Corsp/Notices 6640 W-138H Mandatory Appointment Notice-NPA FS ABAWD Participant to ESP
    07 Corsp/Notices 5033 W-138T Information About an Expedited Food Stamp Interview
    07 Corsp/Notices 6077 W-138TT Notice of Application Interview Appointment
    07 Corsp/Notices 6313 W-139E Notice of DASIS Benefits and Services
    07 Corsp/Notices 6644 W-140JJ Appointment Notice
    07 Corsp/Notices 7014 W-140JJ S Appointment Notice Spanish
    07 Corsp/Notices 1350 W-145HH Decision Notice: Assistance to Meet an Immediate Need
    07 Corsp/Notices 6641 W-145K Voluntary Rent or Utility Restriction Notice
    07 Corsp/Notices 6643 W-145V Notice of Intent to Restrict Rent
    07 Corsp/Notices 1738 W-145VV Notice of Change in Cash Payment for Family Assistance Cases
    07 Corsp/Notices 6046 W-145W Important Notice about your temporary shelter accommodations
    07 Corsp/Notices 6646 W-146A Notice of Participants Receiving Restricted Rent Check
    07 Corsp/Notices 6647 W-146C Notice of Intent to Issue an Advance Allowance for Rent
    07 Corsp/Notices 6090 W-146G Notice of Intent to Issue an advance allowance for rent
    07 Corsp/Notices 6066 W-146Q Likelihood of Becoming a Public Charge
    07 Corsp/Notices 7105 W-158D Notification of Accounts Receivable
    07 Corsp/Notices 7015 W-186 Division of Fair Hearing Rivera Request Receipt
    07 Corsp/Notices 7404 W-186A Rivera Request Response
    07 Corsp/Notices 5430 W-2-112 Change Notice of
    07 Corsp/Notices 6509 W-205 Cancellation of Public Assistance Check
    07 Corsp/Notices 6648 W-273BB Notice of Change in the Way Child Care Ben Are Paid for Ind
    07 Corsp/Notices 6940 W-273V Provider approval and child enrollment notice
    07 Corsp/Notices 6649 W-273Y Notice of Change in the Day Child Care Ben Are Paid for Ind
    07 Corsp/Notices 6958 W-273YY Notice Of Intent To Discontinue Child Care Benefits
    07 Corsp/Notices 8849 W-280C Notice to Report to Family Court
    07 Corsp/Notices 7561 W-280H Appointment to OCSE
    07 Corsp/Notices 6315 W-29 Notice to Applic Recip Regarding Third Party Health Insurance
    07 Corsp/Notices 6226 W-296A Notice of Appointment
    07 Corsp/Notices 6651 W-299G Notification of Continuing Medical Coverage
    07 Corsp/Notices 6548 W-328C Notice to Client Initiation of Two Party Rent payment
    07 Corsp/Notices 7749 W-331A Appeal Call-In Letter Mandatory
    07 Corsp/Notices 7395 W-331A Disability Appeals Unit Mandatory Assessment Interview
    07 Corsp/Notices 8843 W-331H Disability Services Program Initial Assessment Interview
    07 Corsp/Notices 8113 W-333T Drug Treatment Record and Confidential HIV Related Information
    07 Corsp/Notices 7330 W-489A Letter of Intro. Referral to Comm. SRO or Transition Hotel
    07 Corsp/Notices 7133 W-500CC Mandatory Return Appointment
    07 Corsp/Notices 7134 W-500CC S Mandatory Return Appointment Spanish
    07 Corsp/Notices 7016 W-500DD Training Assessment Group Appointment Verification
    07 Corsp/Notices 7234 W-500M Notice to Report Employment Information
    07 Corsp/Notices 7662 W-502 Referral to Back to Work BTW Vendor
    07 Corsp/Notices 7046 W-502 Referral to Skills Assessment and Placement Vendor
    07 Corsp/Notices 6956 W-507A Notice of Applicant Self-Enrollment Training or Educat Pgm
    07 Corsp/Notices 6949 W-531 Important Information About Your Application
    07 Corsp/Notices 7047 W-532A Conciliation Notification
    07 Corsp/Notices 7048 W-532B Conciliation Notification For Activity Period Continued
    07 Corsp/Notices 7135 W-532C Conciliation Notification For Activity Period Continued
    07 Corsp/Notices 0968 W-532D Notice of Employability
    07 Corsp/Notices 7559 W-533H WeCare Mandatory Return Appointment
    07 Corsp/Notices 6316 W-538B Notice to Medical Assistance Program
    07 Corsp/Notices 0872 W-538C Medical Provider Appointment
    07 Corsp/Notices 6941 W-560CC Notice: Eligibility for Transitional Child Care Benefits
    07 Corsp/Notices 6959 W-560DD Notice Of ineligibility Transitional Child Care Bene
    07 Corsp/Notices 6960 W-560EE Notice Of Intent To Change Child Care Benefits
    07 Corsp/Notices 6961 W-560FF Notice Of Delinquent Family Share Child Care Benefits
    07 Corsp/Notices 5028 W-568W Client's Acknowledgment of Changes in Ben PA-FS-MA
    07 Corsp/Notices 7017 W-573XX BEGIN Program Referral Letter
    07 Corsp/Notices 1672 W-574Z Notification of Work Requirement & Right to Contest
    07 Corsp/Notices 6654 W-576X Repayment Letter
    07 Corsp/Notices 6224 W-576Y NOI Data Entry Request for Employment Non-Compliance
    07 Corsp/Notices 6233 W-576Z Notice of Right to Appeal
    07 Corsp/Notices 7106 W-585P 1 orTLEP-30 Client Address Information Request TLEP
    07 Corsp/Notices 7111 W-588Q or RED-500 Not at Home Notice
    07 Corsp/Notices 8270 W-590QQ IREA Liens and Recovery Agreement letter
    07 Corsp/Notices 8271 W-590RR IREA Liens and Recovery Bill
    07 Corsp/Notices 8273 W-590TT IREA Liens and Recovery Deal Is Off letter
    07 Corsp/Notices 8272 W-596B IREA Liens and Recovery Client Lien Amount letter
    07 Corsp/Notices 6515 W-603K Client Notification of Transfer
    07 Corsp/Notices 1434 W-636 Notice of Special Grant
    07 Corsp/Notices 1704 W-700E School Attendance Verification Letter
    07 Corsp/Notices 6234 W-701B Notice of Temp. Removal of Child & Right to Hearing
    07 Corsp/Notices 6049 W-710 Income Maintenance Report of Action Taken
    07 Corsp/Notices 6317 W-723 Facsimile Transmission
    07 Corsp/Notices 8057 W-75 Senior-Works Appointment Letter
    07 Corsp/Notices 7332 W-897A Client Referral Notice to Community Based Organizations
    07 Corsp/Notices 7333 W-897D Notice of Eligibility for HASA Program Admission
    07 Corsp/Notices 7065 W-897G Client Services- Receipt of Documents to Establish Elig
    07 Corsp/Notices 7043 W-901 Notice of Food Stamp Recertification Appointment
    07 Corsp/Notices 7044 W-901 S Notice of FS Recertification Appointment Spanish
    07 Corsp/Notices 7045 W-901A Telephone Recertification Contact Information
    07 Corsp/Notices 8007 W-902J Visit Notification
    07 Corsp/Notices 8596 W-902X Notice to Report Employment or School Attendance
    07 Corsp/Notices 8597 W-902Y Declaration of Employment and/or School Attendance
    07 Corsp/Notices 6318 W-904DD Notice To Recipients
    07 Corsp/Notices 1454 W-908CC Notice of Rescheduled Appointment
    07 Corsp/Notices 7557 W-908D Data Sheet
    07 Corsp/Notices 7558 W-908E Automated Telephone Recertification
    07 Corsp/Notices 1462 W-908T Recertification Appointment Letter
    07 Corsp/Notices 1466 W-908VV Referral Appointment Letter
    07 Corsp/Notices 1582 W-908W Recertification Appointment Letter-Spanish
    07 Corsp/Notices 6813 W-912HH Request for Info from Employer
    07 Corsp/Notices 1562 W-912HH Request for Information From Employer
    07 Corsp/Notices 6235 W123GG Notice to Bring in Photo ID in order to get FS Benefits
    07 Corsp/Notices 1722 W186hh Notice of Mandatory Dispute Resol Adequacy Denial Notice
    07 Corsp/Notices 6207 W519E Finger Imaging Notice
    07 Corsp/Notices 6230 W612 Notice of Intent Change Continue or Benefits PA-FS and MA
    07 Corsp/Notices 6237 W701C Protective Custody Emergency Removal
    07 Corsp/Notices 8599 Wellness Plan Follow-Up (WeCare)
    07 Corsp/Notices 7121 XLO114 22 month time limit letter
    08 II/AA 6320 ACD 1039 Medical Referral or Referido Medico
    08 II/AA 7024 ACD-1122 Payment to Provider for Child Care
    08 II/AA 1694 ACS Referral Statement
    08 II/AA 8259 ACS/CCSS Program/Provider Packet
    08 II/AA 8679 ADA Compliance Officer Appeal Decision Letter
    08 II/AA 5047 ADC-BEGIN Fair Hearing Action Sheet
    08 II/AA 5962 Application Interview Referral Form
    08 II/AA 8265 b-83 Client Locate Letter Monies Due
    08 II/AA 8266 b-83A Client Locate Letter Moines Due Over 2 Years
    08 II/AA 1586 BEV Compliance Letter
    08 II/AA 8425 BFI- Arrest Notification Form
    08 II/AA 8447 BFI-101 Return Appointment to
    08 II/AA 8451 BFI-131D Social Security Number Validation
    08 II/AA 8449 BFI-132a Signature and Witness List
    08 II/AA 8453 BFI-132B Summary of Fraud Activity
    08 II/AA 8426 BFI-132G Authorization to Release Info
    08 II/AA 8443 BFI-135 Request to Change information
    08 II/AA 8427 BFI-138 DFRP FSCAR Referral
    08 II/AA 8423 BFI-142 Agency Witness Sheet
    08 II/AA 8445 BFI-145 Required Statistical Action
    08 II/AA 8446 BFI-145 Restitution Memorandum
    08 II/AA 8442 BFI-150A Request for Restitution
    08 II/AA 8444 BFI-151 Request for Marriage Records
    08 II/AA 8452 BFI-152 Summary of Civil Action
    08 II/AA 8435 BFI-156 Original Rent Checks request
    08 II/AA 8454 BFI-160 Summary of IPV Act and Exhibits
    08 II/AA 8424 BFI-161 Arrest Data
    08 II/AA 8421 BFI-163 Access to Records for MA services
    08 II/AA 8428 BFI-200 Transmittal to FSCAR
    08 II/AA 7037 BFI-21B Report of Investigation
    08 II/AA 8430 BFI-22E Chronological Developments
    08 II/AA 8429 BFI-25D Child Care Provider Call in letter
    08 II/AA 8434 BFI-33 Notice of Absent Parent Information
    08 II/AA 8455 BFI-40 Voluntary Restitution
    08 II/AA 8450 BFI-42 Sign in Sheet
    08 II/AA 8420 BFI-4450 OMIG Referral
    08 II/AA 8440 BFI-45 Report of Interview
    08 II/AA 8431 BFI-50 MA Closing Referral
    08 II/AA 8468 BFI-Match Information
    08 II/AA 8432 BFI-Medicaid IG - Restriction Referral Form
    08 II/AA 8433 BFI-Miranda Warning
    08 II/AA 8058 Biopsychosocial Evaluation
    08 II/AA 8059 Biopsychosocial Evaluation Specialties
    08 II/AA 8289 CA Application Package/CA FFR Package HASA
    08 II/AA 8630 CAS-301 WeCare Functional Capacity Outcome Appointment
    08 II/AA 8632 CAS-316A WeCare Employment Program Services
    08 II/AA 8633 CAS-316E WeCare Education/Training Services
    08 II/AA 8634 CAS-316T WeCare Rehabilitation Program Services
    08 II/AA 8713 CAS-316W WeCare New Service Provider
    08 II/AA 8631 CAS-322 WeCare Assessment for a Clinical Review
    08 II/AA 8850 CAS-499 Appointment for Evaluation for a Work Activity
    08 II/AA 8410 CAS-DSP Additional Info Packet
    08 II/AA 8074 CASAC Assessment Summary
    08 II/AA 5053 Case Involvement History Screen
    08 II/AA 7597 CAVU-Review Findings Centralized Alien Verification Unit
    08 II/AA 8286 CBO Referral Package/Documentation HASA
    08 II/AA 6390 Claims Prescreening Form
    08 II/AA 8075 Clinical Review Team CRT
    08 II/AA 0864 Closing Letter from Welfare Agency or Program
    08 II/AA 6195 Community Center Service Network Project Referral or Information
    08 II/AA 8061 Comprehensive Service Plans
    08 II/AA 8069 Comprehensive Service Plans Fully Employable
    08 II/AA 5054 Consent for Release of Medical Psychiatric Information
    08 II/AA 8070 Consents
    08 II/AA 7693 CS-101 Mandatory Return Appointment to ACS
    08 II/AA 8809 CS-1066 Mail in Recertification of Eligibility for Child Care Services
    08 II/AA 8810 CS-1066A Eligibility for Child Care Services
    08 II/AA 7695 CS-273UU Child Care Provider Income Verification Letter
    08 II/AA 8253 CS-574FF Proof of ID and Residency for Your Child Care Provider
    08 II/AA 1210 D & C Notice of PA Check Cancellation
    08 II/AA 5055 Department of Motor VehiclesTraffic Violations Report
    08 II/AA 7632 DHCR or for apt buildings w 6 units - New Apartment Rent
    08 II/AA 7189 DHS Client's Request for Rent Payment of EARP Supplement
    08 II/AA 7028 DHS-432G Medicaid Clearance Form
    08 II/AA 8062 Diagnostic Vocational Evaluation
    08 II/AA 7687 Document Receipt from Community Based Organization CBO
    08 II/AA 8752 Documentation re-establishing ABAWD eligibility
    08 II/AA 6008 Documentation Required for Eligibility Determination
    08 II/AA 8993 DOL-Data Match
    08 II/AA 0200 Drug or Alcohol Program Letter
    08 II/AA 7882 DSP SSA Forms
    08 II/AA 8312 DSP-Appeal Assessment Form
    08 II/AA 7884 DSP-ONLY Miscellaneous Document
    08 II/AA 1574 DSS-2221A Report of Suspected Child Abuse or Maltreatment
    08 II/AA 0988 DSS-2474 SSI Referral
    08 II/AA 5960 DSS-2633 Application for Emergency Assistance for Adults
    08 II/AA 0848 DSS-2640 Request for Services or DSS or VA Referral
    08 II/AA 5058 DSS-2846 Fair Hearing Disposition Notice of
    08 II/AA 1578 DSS-2921 Application for PA-MA-FS Benefits-Spanish
    08 II/AA 5477 DSS-2924P Medicaid WIC/Application for Pregnant Women Young Children
    08 II/AA 6529 DSS-2943 Individual or Family Services Plan
    08 II/AA 6322 DSS-2949 Personal Data Sheet Progress Report
    08 II/AA 6323 DSS-3021 AFDC or SSI Interagency Request
    08 II/AA 5994 DSS-3151 Commission for the Blind and Visually Handicapped Eye Report
    08 II/AA 8162 DSS-3603 Initial Assessment-Service Plan Review
    08 II/AA 5496 DSS-3608 Recertification Guide
    08 II/AA 6567 DSS-3668 Shelter Verification
    08 II/AA 5062 DSS-3722 Fair Hearing Update Data Entry Form
    08 II/AA 6019 DSS-3774 EPFT Benefits to be pulled - data entry form
    08 II/AA 5951 DSS-4002F Action Tkn on request for assist to meet immdat need
    08 II/AA 5968 DSS-414 Authoriz for Reimbursement of Interim Assist SSI Determination
    08 II/AA 5959 DSS-4148A Application
    08 II/AA 8750 DSS-4163 MOF/Submission Form
    08 II/AA 6871 DSS-4482-10 Fair Hearing Decision To Applicant
    08 II/AA 5060 DSS-457 Fair Hearing Schedule Notice of
    08 II/AA 1154 DSS-4571 Alcohol Substance Abuse Screening
    08 II/AA 1594 DSS-4571S Alcohol Substance Abuse Screening-Spanish
    08 II/AA 6554 DSS-4718 Race/Ethnic Code Data Entry Form
    08 II/AA 6325 DSS-649 PCAP Transmittal to City or DSS
    08 II/AA 6664 EBT-14 Referral to Fraud Investigation Fraud
    08 II/AA 7690 EBT-64 Customer Service ARU PIN Restriction Permission
    08 II/AA 5542 EC-23 WCB Notice of Decision
    08 II/AA 6327 Eligibility Interview Guide and Workbook
    08 II/AA 6749 EXP-53J Transitional Support Payment Income Comparison Worksheet
    08 II/AA 7916 EXP-75 Grant Diversion Program Letter
    08 II/AA 8163 EXP-85MM Notice to Report to Center
    08 II/AA 8224 EXP-86D Notice of Decision on HRA Bonus Payment
    08 II/AA 8178 Fair Hearing Added EEPS Documents
    08 II/AA 1190 Fair Hearing Aid-To-Continue Documentation
    08 II/AA 8177 Fair Hearing Appellant Information
    08 II/AA 8194 Fair Hearing Centralized Resolution Documents
    08 II/AA 1186 Fair Hearing Decision
    08 II/AA 5781 Fair Hearing History Sheet
    08 II/AA 7468 Fair Hearing Packet 98A Fair Hearing Packet
    08 II/AA 7467 Fair Hearing Packet Aid To Continue ATC
    08 II/AA 7790 Fair Hearing Packet Compliance Review
    08 II/AA 8305 Fair Hearing Packet Home Care
    08 II/AA 7791 Fair Hearing Packet Non-Cash Assistance Food Stamp
    08 II/AA 7801 Fair Hearing Packet Rivera Processing
    08 II/AA 7465 Fair Hearing Packet Rivera request issues
    08 II/AA 5061 Fair Hearing Update Data Entry
    08 II/AA 7081 Family Permanency Conference Service Plan Agreement
    08 II/AA 8658 Federal Disability Form WeCARE
    08 II/AA 8753 FIA 1021a Notice of Need to Reestablish ABAWD Eligibility
    08 II/AA 8306 FIA-1004 Recoupment Overpayment Worksheet
    08 II/AA 8307 FIA-1004a Recoupment Action History Sheet
    08 II/AA 8301 FIA-1018 Over the Counter Card Cancellation
    08 II/AA 8299 FIA-1021 Notice of Able-Bodied Adult without Dependents (ABAWD) Status
    08 II/AA 8751 FIA-1021b Declaration of Job Search Activities
    08 II/AA 8793 FIA-1021D Able-Bodied Adult without Dependents Compliance Notice
    08 II/AA 8828 FIA-1021i Notice of an Offer of Work Activity
    08 II/AA 8862 FIA-1021K Offer of Work to an Able-Bodied Adult Without Dependents
    08 II/AA 8492 FIA-1059 Replacement of Common Benefit Identification Card
    08 II/AA 8659 FIA-1068 Notice to Individuals Who Entered the United States
    08 II/AA 8629 FIA-1076 Important Notice to Participants Re: Incorrect NOI.
    08 II/AA 8680 FIA-1084 Statewide Clearance Contact
    08 II/AA 8138 Final Notice Fair Hearing Compliance
    08 II/AA 5067 Fraud Alert
    08 II/AA 6631 Fraud Announcements
    08 II/AA 8288 FS Only Package HASA
    08 II/AA 5068 HA-501-U5 Hearing by Administrative Law Judge Request for
    08 II/AA 6328 HA-520-U5 Request for Review of Hearing Decision
    08 II/AA 7974 HA-L32 Electronic Disability Claims Processing
    08 II/AA 7683 HASA CASAC Assessment
    08 II/AA 7684 HASA Case Record
    08 II/AA 7685 HASA Case Transfer
    08 II/AA 7680 HASA CBCFA Package
    08 II/AA 8667 HASA Child Care Provider Enrollment Package
    08 II/AA 7888 HASA EPU-Emergency Placement Unit Package
    08 II/AA 8600 HASA Housing Case Conference
    08 II/AA 8251 HASA Incident Report
    08 II/AA 8250 HASA Legally-Exempt Child Care Forms
    08 II/AA 7682 HASA Mental Health Assessment
    08 II/AA 8140 HASA Referral Letter
    08 II/AA 8348 HASA Restricted Access Letter
    08 II/AA 7681 HASA ServiceLine Package
    08 II/AA 8601 HASA Transportation Request Packages for Out-of-City Moves
    08 II/AA 7877 HASA-HMK HASA Homemaking Archive
    08 II/AA 6331 HCSP-3001 CASA-MEU Information Form Soc worker sta
    08 II/AA 8527 HCSP-3009 Reauthorization Package Renewal Reminder
    08 II/AA 8004 HCSP-710B Home Care Services Program Intake Form
    08 II/AA 8342 HCSP-710C Request for Notice Intent
    08 II/AA 8200 HCSP-711B HCAPS Referral Notices
    08 II/AA 8201 HCSP-711C HCHASA Referral Notices
    08 II/AA 8202 HCSP-711E HC Incomplete Application
    08 II/AA 6244 HDU Diversion Weekly Reporting Form
    08 II/AA 6181 HDU Referral to Community Based Organization on Form
    08 II/AA 6243 HDU Rental Assistance Approval or Denial Form
    08 II/AA 6568 HHC 50-287 Special Application for a Copy of a Birth Certificate
    08 II/AA 6185 HHC-884 Application for Metropolitan Health Plan or HMO
    08 II/AA 5070 History Sheet any kind
    08 II/AA 8992 Home care Reauthorization Packet
    08 II/AA 8991 Home Care Recertification/Reauthorization Packet
    08 II/AA 8076 Home Visit Documentation
    08 II/AA 7628 Homebound only - Immediate Needs
    08 II/AA 5809 Homeless Individual History Sheet
    08 II/AA 8183 HRA Incentive Bonus Documents
    08 II/AA 8334 HRA-102 Request for Appeal of Reasonable Accommodation Determination
    08 II/AA 8672 HRA-107 Reinstatement of Split-Shift Home Care Services
    08 II/AA 5073 HS Systems Questionnaire 2 pages
    08 II/AA 0860 HSS Medical Information
    08 II/AA 5943 HSS Medical Referral Letter
    08 II/AA 1166 HSS Medical Results
    08 II/AA 1170 HSS Results of SN Appt
    08 II/AA 7091 HUD-52517 Request for Tenancy Approval
    08 II/AA 5074 Income Maintenance of Child's Placement/Discharge Notification to
    08 II/AA 6056 Inquiry Clearance
    08 II/AA 7410 JTP Client case notes letters notices forms
    08 II/AA 8067 Lab Results
    08 II/AA 8223 LDSS-2425 Repayment of Interim Assistance Notice
    08 II/AA 8269 LDSS-2425A Repayment of Interim Assistance Notice
    08 II/AA 1214 LDSS-2921 Application for PA-MA-FS Benefits
    08 II/AA 8021 LDSS-2921A Emergency Assistance For Adults Applicant Statement
    08 II/AA 1218 LDSS-3174 Recertification for PA-MA-FS
    08 II/AA 5334 LDSS-3517 Turn Around Document TAD
    08 II/AA 8134 LDSS-4007 Notice of Decision of Initial Authorization
    08 II/AA 8199 LDSS-4007B HCPS Authorization No Aid
    08 II/AA 8135 LDSS-4008 Notice to Reduce or Discontinue Personal Care
    08 II/AA 8136 LDSS-4263 Notice to Authorize Response Services
    08 II/AA 8132 LDSS-4273 Notice to Discontinue Personal Care
    08 II/AA 8133 LDSS-4274 Notice to Increase or Decrease Personal Care
    08 II/AA 7846 LDSS-4529 Agreement to Repay Safety Net Assistance Still Owed
    08 II/AA 7230 LDSS-4647 Important Information about Child Care
    08 II/AA 7482 LDSS-4707 Intentional Program Violation IPV Ancillary Doc
    08 II/AA 7149 LDSS-4732-A DFR Cover Letter And Response Form
    08 II/AA 0856 Letter from Welfare Agency or Program
    08 II/AA 5077 Lift Sanction Letter
    08 II/AA 8715 LR-212 IREA Supplemental Needs Trust Request for Documentation
    08 II/AA 8513 LTC Fair Hearing Packet
    08 II/AA 6036 M-11a Home Care Services Program service request and authorization
    08 II/AA 8203 M-11K HC Final Notices
    08 II/AA 1616 M-11q Medical Request for Home Care
    08 II/AA 6804 M-15 Inq Regarding Vets' Benefits and Servicemen's Allotments
    08 II/AA 7073 M-183r Address Information Request
    08 II/AA 6024 M-186 Fair Hearing Documentation
    08 II/AA 6336 M-186 PA Fair Hearing Decision Tracking Sheet
    08 II/AA 6434 M-186a Conference Report
    08 II/AA 7694 M-186ce M-186ce Clinical Consultant Fair Hearing Review
    08 II/AA 1726 M-186dd Withdrawal of Fair Hearing Request
    08 II/AA 7286 M-186f Fair Hearing Representative Summary
    08 II/AA 6085 M-186F Notice of Fair Hearing Disposition
    08 II/AA 5085 M-186mm PA Fair Hearing Decision Tracking Sheet
    08 II/AA 6146 M-186PP Resolving Fair Hearing Issues
    08 II/AA 6032 M-186q Food Stamp Fair Hearing Decision Tracking Sheet
    08 II/AA 6020 M-186qq Relevant Case Folder or Evidence Packet Chcklst FH Summary
    08 II/AA 6739 M-186tt Mandatory Dispute Resolution - No Action Taken
    08 II/AA 6165 M-255A Transmittal of Active Cases transferred ATD's
    08 II/AA 1242 M-273 Motor Vehicle Questionnaire
    08 II/AA 1674 M-30P ICP IS-Job Center Match Follow-up Memo
    08 II/AA 5052 M-30x Case Action Worksheet
    08 II/AA 1490 M-31b Social Security Number Discrepancy on Closed Case
    08 II/AA 6152 M-31D Social Security Validation Report Worksheet
    08 II/AA 1486 M-31h Request for Correction of Information
    08 II/AA 1146 M-325A Statement of Lost Theft of Proceeds of PA Check
    08 II/AA 7400 M-325c Stop Payment Order
    08 II/AA 1206 M-325T Affidavit of Loss Theft Non-receipt of PA Check
    08 II/AA 5978 M-327 Case Update Questionnaire We are updating information PA-FS-MA
    08 II/AA 1740 M-327e Sixty Month Time Limit Checklist
    08 II/AA 8254 M-328d Notice of Completed Recoupment
    08 II/AA 8001 M-328l1 Timely Aid-Continuing Fair Hearing Language Insert
    08 II/AA 8002 M-328l2 Conference and Fair Hearing Information
    08 II/AA 6512 M-392A Case Review Record
    08 II/AA 1604 M-42f Referral Separate Determination of Medical Assistance
    08 II/AA 6741 M-42g Referral for Medicaid Eligibility Determination
    08 II/AA 1608 M-42n Transmittal to Medical Assistance Programs
    08 II/AA 6557 M-442 Referral Summary Form for Clients Moving Permanently Out of NYS
    08 II/AA 7283 M-442j Referral Summary Form For Clients Moving Out of NY State
    08 II/AA 7284 M-463 Application For Life Line Telephone Service
    08 II/AA 6532 M-58G Intake Clearance Form or Request for Case Record
    08 II/AA 1750 M-687m Safety Net Assistance Application Supplement
    08 II/AA 5093 M-687r Referral to Treatment Program
    08 II/AA 6786 M-74b Referral to Substance Abuse Service Center - SPV Assignment
    08 II/AA 6787 M-74d Employment Services Referral Form
    08 II/AA 6566 M-75c RTC Application Development Form
    08 II/AA 5950 M-75e Action Taken on your application PA-FS-MA
    08 II/AA 6809 M-75j Notification of CASAC Assessment Outcome
    08 II/AA 6811 M-75p Consent for Release of Info to Employment Vendor
    08 II/AA 6812 M-75w Consent for Release of Info from Treatment Program
    08 II/AA 6740 M-85 ORI/CMU Report of Bureau of Fraud Investigation Case Action Taken
    08 II/AA 6742 M-858m Utility Arrears or Emergency Heating
    08 II/AA 7626 M11-S-Homecare initial
    08 II/AA 7627 M11TR-Homecare Reauthorization
    08 II/AA 7625 M14P Homecare initial
    08 II/AA 7875 M20B Homemaker Service Report
    08 II/AA 7876 M20TR Authorization to Extend Homemaking Service
    08 II/AA 6355 MAP /E C507 SSI Unit-Request for Information
    08 II/AA 6357 MAP /E E316 Referral for Supplemental Security Income
    08 II/AA 6553 MAP 2052W DSS-486 Provider Refusal to Complete Form
    08 II/AA 6351 MAP 2055H Data Entry Error Correction Control Form
    08 II/AA 6521 MAP 2116 HED-Daily MES Case Submission Report
    08 II/AA 7138 MAP-2002D Referral For a Food Stamp Eligibility Determination
    08 II/AA 6539 MAP-2009 New York State Restricted Recipient Program
    08 II/AA 6258 MAP-2026D Transmittal to SSN Validation Liaison
    08 II/AA 6239 MAP-2043E Referral to Off Of Rev and Invest For Guardian Infl
    08 II/AA 5527 MAP-2088N Action Notice App Benefit For MA COBRA Premium Payment
    08 II/AA 5528 MAP-2088Q Notice App MA Pymnt Ins Prem Undr AIDS Hlth Ins Prgrm
    08 II/AA 6352 MAP-2100 Referral to ORI Real Property and Assets Section
    08 II/AA 5564 MAP-2109 Referral to Map Resource Unit
    08 II/AA 5532 MAP-2158D Notice to MA BuyIn Appl W Xcess Income MAP-258D replaces
    08 II/AA 5530 MAP-2158K Action Notice MA Premium Pymnt Prgrm MAP-258K replaces
    08 II/AA 8403 MAP-258P NYSDOH Income Report from SSA Records
    08 II/AA 7849 MAP-25F OED Case History Review Sheet
    08 II/AA 8283 MAP-25M CED Case History Review Sheet
    08 II/AA 8590 MAP-3001-cover/3002(E/S) Nursing Home Renewal
    08 II/AA 8313 MAP-3003 SSA CITIZENSHIP/IDENTITY MATCH 90-DAY NOTICE
    08 II/AA 8589 MAP-3036 Referral to Office of Legal Affairs
    08 II/AA 7932 MAP-316H Response to Request For Evidence Packet
    08 II/AA 6249 MAP/C P1345 Restricted Recipient Program Review Sheet
    08 II/AA 7852 Medical Bills for MKB Retroactive Relief Project
    08 II/AA 6591 Memorandum - Division for Youth EAF
    08 II/AA 6531 MEP-2159D Institutional Services Recertification Deferral Form
    08 II/AA 6072 Message from Social Security about your baby's social security card
    08 II/AA 0076 Methadone Program ID
    08 II/AA 8068 Miscellaneous Findings or Tests
    08 II/AA 7853 MKB Retroactive Relief Project Review Packet
    08 II/AA 7601 MKB-83J MKB Notice of Determination
    08 II/AA 7960 MKB-83Z MKB Notice of Non-Class Member Determination
    08 II/AA 0876 Notice of Eligibility Recommendation
    08 II/AA 8743 Notice of Intent to Reduce Public Assistance Public Shelter Resident
    08 II/AA 6101 Notice to Social Services
    08 II/AA 8073 NOWR
    08 II/AA 5082 NY State Dept of Labor Determination to Claimant Notice of
    08 II/AA 5083 NYC Dept of Probation Conditions of Probation Addendum
    08 II/AA 5084 NYS DSS AFIS Report of Match Results
    08 II/AA 6612 NYS OCFS IV-Emedicaid or EAF Appl
    08 II/AA 6608 NYS OCFS or Case Closing
    08 II/AA 6613 NYS OCFS or Notice of Eligibility
    08 II/AA 6610 NYS OCFS or Transmittal for VOA & 638J
    08 II/AA 6614 NYS OCFS Verification of Assistance Worksheet Federal Resources Unit
    08 II/AA 8676 NYS-Confirmation Letter for Human Trafficking Victim
    08 II/AA 8678 NYS-Minor Individual Referred As a Human Trafficking Victim
    08 II/AA 8677 NYS-Service Notice for Human Trafficking Victim
    08 II/AA 7908 OCA 960 Authorization To Release Health Information Pursuant To HIPAA
    08 II/AA 8854 OCFS-4915 History of Criminal Convictions and Parental Acknowledgment
    08 II/AA 8855 OCFS-4916 History of Day Care Enforcement and Parental Acknowledgment
    08 II/AA 8856 OCFS-4917 History of Termination of Parental Rights
    08 II/AA 8857 OCFS-LDSS-4699 Legally Exempt Family Child Care or in Home Child Care
    08 II/AA 8252 OCFS-LDSS-4699.2 Legally-Exempt In-Home Child Care Provider Agreement
    08 II/AA 0868 OCSE Results
    08 II/AA 7741 Office of Project Support Exhibit A
    08 II/AA 7742 Office of Project Support Exhibit B
    08 II/AA 7743 Office of Project Support Exhibit C
    08 II/AA 1048 ORI Referral Results
    08 II/AA 7041 ORI Referral to FIA Re Monetary Lawsuit Settlement
    08 II/AA 8071 Outreach Documents
    08 II/AA 6388 PCAP Recertification Notice
    08 II/AA 5086 Physician's Certification of Borrower's Total and Permanent Disability US DoE
    08 II/AA 8080 Physicians Functional Assessment Form
    08 II/AA 5087 Pre-Enrollment Agreement
    08 II/AA 5090 Pre-Fair Hearing Summary
    08 II/AA 6121 Presumptive Eligibility Application
    08 II/AA 6799 Project Cooperation Job Center Referral Form
    08 II/AA 8285 PRUCOL Documentation HASA
    08 II/AA 8089 Psychiatric Evaluations
    08 II/AA 1150 Recommendation from AOM
    08 II/AA 6724 Recoupment of Child Support Payments
    08 II/AA 7095 RED 17-1 Field Investigation Report-Center 17
    08 II/AA 7097 RED 17-3 RED Field Investigation Report-Shelter Case
    08 II/AA 7099 RED-25 Recertification Eligibility Division-Investigative Notes
    08 II/AA 0980 Referral from Family Court
    08 II/AA 0852 Referral from Shelter
    08 II/AA 6332 Referral Information
    08 II/AA 0972 Referral or Results from OES
    08 II/AA 6140 Request for Hearing by Administrative Law Judge
    08 II/AA 7619 Request for Service Line Eligibility Determination form-HASA
    08 II/AA 6565 Result of Conference with PA Recipient Contesting Rent Arrears Payment
    08 II/AA 5416 Returned Mail
    08 II/AA 8119 Rivera Certificate of Mailing
    08 II/AA 8343 RTSC Only-CASAC Packet
    08 II/AA 1174 SACC Results
    08 II/AA 8016 Scatter-site ll Case Assessment by HASA
    08 II/AA 8015 Scatter-site ll Case Assessment by Provider
    08 II/AA 8588 Service Line Application Packet
    08 II/AA 0984 SSA Referral
    08 II/AA 7794 SSA-003 Acknowledged Receipt of Hearing Request
    08 II/AA 5049 SSA-1696-U4 Appointment of Representative
    08 II/AA 5057 SSA-4268-C4 Explanation of Determination
    08 II/AA 5091 SSA-561-U2 Reconsideration Request for
    08 II/AA 5050 SSA-827 Authorization for Source to Release Information to SSA
    08 II/AA 7764 SSA-L8165 Explanation of Benefit Payment
    08 II/AA 6346 SSA-L8170 Overpayment Summary
    08 II/AA 6347 SSA-L928-U2 Social Security Notice of Reconsideration
    08 II/AA 7697 SSI Fair Hearing Packet
    08 II/AA 8065 SSI or SSDI Application
    08 II/AA 8066 SSI or SSDI Supporting Documentation
    08 II/AA 8520 State Online Query System (SOLQ) Referral)
    08 II/AA 0924 Statement from Agency or Program
    08 II/AA 5759 Structured History Sheet - Mail Recertification Project
    08 II/AA 8511 Substance Abuse Certificates of Completion
    08 II/AA 5753 Support Collections Unit Letter
    08 II/AA 6795 TEAP Participant Statement of Understanding
    08 II/AA 5096 TIU Change Referral
    08 II/AA 8214 Transitional Child Care Approval Documents-FOR TCC USE ONLY
    08 II/AA 8215 Transitional Child Care Disapproval Documents-FOR TCC USE ONLY
    08 II/AA 8072 VRS Supporting Documentation
    08 II/AA 6348 W-10 Dependant Care Provider's Identification and Certification
    08 II/AA 6028 W-106 Follow up card
    08 II/AA 5990 W-112 Clearance Report on Applicant
    08 II/AA 5048 W-112C Application Control Card
    08 II/AA 1286 W-113E Information Referral Notice
    08 II/AA 5964 W-113M Appointment Notice and Documentation Guide
    08 II/AA 6211 W-123GG Food Stamp Photo ID Card Referral
    08 II/AA 6135 W-124H Report of Claim Determination
    08 II/AA 6209 W-129PP Food Stamp Eligibility Interview Appointment Notice
    08 II/AA 6433 W-129RR Important Notice Of Recertification Appointment Page 1
    08 II/AA 6210 W-132A Food Stamp Eligibility Determination History Sheet
    08 II/AA 1652 W-132DD Transmittal of IS-Job Center Food Stamp Case to NPA FS Center
    08 II/AA 1632 W-132K Referral To NPA Food Stamp Center
    08 II/AA 1636 W-132N Referral to On-Site Medicaid Liaison Medicaid Office
    08 II/AA 6632 W-134 Homebound Notice of Mail Certification Request for Documentation
    08 II/AA 6511 W-136 Case Rejection Audit
    08 II/AA 7148 W-137E Request to Pend an Application
    08 II/AA 1314 W-138V Eligibility Determination History
    08 II/AA 6360 W-140DD New Claim Calculation Worksheet
    08 II/AA 5899 W-140K Receptionist's Expedited Service Worksheet
    08 II/AA 6579 W-140M Discrepant Eligibility Information Tracking & Prescreening
    08 II/AA 8124 W-140WW Intensive Services Call In
    08 II/AA 1346 W-145F Recoupment Worksheet to Determine Hardship
    08 II/AA 7689 W-145G DHS or Shelter Facility Referral Form
    08 II/AA 7325 W-146T Authorization f or Release of Confidential HIV Related Info
    08 II/AA 6560 W-147A Replacement of Direct Vendor Payments
    08 II/AA 7699 W-147FF Claims and Collection Response
    08 II/AA 7147 W-147J NYCHA Commitment Form
    08 II/AA 5051 W-151L BCFI or FEDS Referral
    08 II/AA 1158 W-151N Citizenship NYC Referral
    08 II/AA 1854 W-153R Rental Assistance Unit Exception Policy
    08 II/AA 5851 W-154A CIS Referral
    08 II/AA 5999 W-164M Contact/Processing Summary
    08 II/AA 6362 W-180N CWA-Hospital Transfer Summary
    08 II/AA 8166 W-180R Fair Hearing-Conference Unit Referral for Eligibility Review
    08 II/AA 6976 W-186C Fair Hearing compliance statement
    08 II/AA 6569 W-186D Fair Hearing Compliance Request
    08 II/AA 8486 W-186E Fair Hearing Tracking Sheet
    08 II/AA 5056 W-2-188 Dept of Homeless Letterhead NYC
    08 II/AA 7569 W-200B Inter-Agency Date of Status or Date Entered Country Transmt
    08 II/AA 6363 W-203WW Data Entry Error Correction Transmittal
    08 II/AA 1730 W-204R Mandatory Dispute Resolution MDR Summary
    08 II/AA 6364 W-205S Selective Case Review Classification
    08 II/AA 6073 W-205T Case Review Alert
    08 II/AA 6037 W-208A Home Delivery Sheet of Public Assistance Checks
    08 II/AA 6718 W-209 Important Notice to Recipient About Child Support Bonus Payment
    08 II/AA 1402 W-25 History Sheet
    08 II/AA 1406 W-25D Request for Case Reopening
    08 II/AA 1570 W-25H Alien Status Review History Sheet
    08 II/AA 1522 W-270 Routing Control Sheet
    08 II/AA 5403 W-270A Routing Control Sheet
    08 II/AA 7566 W-274Z Referral Appointment Notice to from ACS Child Care Unit
    08 II/AA 7983 W-280N Locate Postal Clearance Letter
    08 II/AA 8168 W-280W Verified Employment of Non-Custodial Parent
    08 II/AA 8595 W-286K Professional License Payment Agreement Violation Notice
    08 II/AA 5158 W-293U Child/Teen Health Plan Informing & Offering Statement
    08 II/AA 6134 W-294D C-THP Reply Form (MAP-1096M E-S Replaces
    08 II/AA 6006 W-296P Documentation Guide for Recertification
    08 II/AA 6007 W-298 Documentation Guide for Recertification
    08 II/AA 7800 W-299 Notice to Applicants Regarding Third Party Health Insurance
    08 II/AA 6977 W-299A Request for payments of Third Party Health Insurance
    08 II/AA 6558 W-30M Rejection Summary
    08 II/AA 6589 W-30P Memorandum - Case being referred to ISC for follow-up action
    08 II/AA 5977 W-30V Case Closing
    08 II/AA 6164 W-30Z Transfer to Summary
    08 II/AA 7977 W-333N DSP Mandatory Assessment Call in for Seniors
    08 II/AA 1530 W-34A Referral Information Form
    08 II/AA 1612 W-34A Referral Information Form
    08 II/AA 5993 W-393B Client Treatment Program Information
    08 II/AA 6524 W-395 HRA Medical History and Examination
    08 II/AA 5078 W-4 Memorandum
    08 II/AA 5079 W-4-500M Memorandum
    08 II/AA 5972 W-401A BFI DFRP FO Referral X1103
    08 II/AA 6370 W-442X Meal Preparation Assessment Form
    08 II/AA 7326 W-448GG Initial Client Information Sheet
    08 II/AA 6038 W-450A Homelessness Diversion Intake Tracking Sheet
    08 II/AA 6559 W-450D Rent Arrears Alert Data Entry Form
    08 II/AA 6112 W-453 Outcome report from job pathway center to income support center
    08 II/AA 0892 W-456AA SACC Referral Letter
    08 II/AA 7327 W-488H HASA Case Problem/Action Form
    08 II/AA 7653 W-488K Case Transfer Summary
    08 II/AA 7648 W-488N Sub-Impress Authorization Form
    08 II/AA 7666 W-488Q Primary Tenant Statement Re Occupancy of Second Tenant
    08 II/AA 6245 W-488X Request for Program Admission
    08 II/AA 7647 W-488Y Field Visit Itinerary
    08 II/AA 7656 W-490M HASA Client appeal process
    08 II/AA 5080 W-5 Memorandum
    08 II/AA 8160 W-500ZZ Training Documentation Return Appointment
    08 II/AA 8197 W-502E CUNY Jobs Plus Program Assignment Letter
    08 II/AA 1534 W-515 General Release
    08 II/AA 5145 W-515J Certification/Recertification Checklist
    08 II/AA 5399 W-515N Referral to Citizenship-NYC
    08 II/AA 6870 W-515X Systematic Alien Verification for Entitlements
    08 II/AA 6147 W-518 Resource Analysis and Plan of Action
    08 II/AA 5065 W-519 Finger Imaging Notice
    08 II/AA 8146 W-519C Finger Imaging Report Routing Slip
    08 II/AA 8221 W-519N Finger Image Requirements for Food Stamp Clients
    08 II/AA 8222 W-519P Finger Imaging Centers for Food Stamp Clients
    08 II/AA 6098 W-523A Notice to Applicant Referral for Elig Verification Review
    08 II/AA 8231 W-523R Applicant Referral to Bureau of Eligibility Verification
    08 II/AA 1538 W-525 Referral for Fraud Investigation Refund Summary
    08 II/AA 6129 W-525W Referral for Eligibility Verification
    08 II/AA 6373 W-532A Referral for Eligibility Verification Review
    08 II/AA 0976 W-532R Notice to ApplicantReferral for Eligibility Verification
    08 II/AA 6100 W-532UU Notice to Report for Public Assistance Eligibility Review
    08 II/AA 1640 W-532X Daily Record of I Interviews
    08 II/AA 6441 W-532Z Notice to Client Referral for Eligibility Review
    08 II/AA 6537 W-534C New Application Questionnaire
    08 II/AA 6374 W-538 Physician's Functional Assessment Form
    08 II/AA 5076 W-573M Language Program Referral Letter
    08 II/AA 7036 W-585A Settlement Form - Report of Action Taken
    08 II/AA 6014 W-586D Elig Verification Review Report of Eligibility Recommendation
    08 II/AA 6203 W-586N BEV/Medicaid Interview Check off Sheet
    08 II/AA 7108 W-587E Undercare field data entry form or recommendation screen
    08 II/AA 6519 W-587P BEV Interview and Field Investigation Report
    08 II/AA 6012 W-588B Eligibility Verification Review Home Visit
    08 II/AA 7183 W-590C BEV Phone Bank Alert Notice Of Rescheduled Home Appoint
    08 II/AA 6672 W-590H Child Information Attestation Document RED-6a
    08 II/AA 6673 W-590J Financial Information Attestation Document RED 7-a
    08 II/AA 8274 W-590UU IREA Liens and Recovery Infant Lien Amount letter
    08 II/AA 8275 W-590VV IREA Liens and Recovery Insurance Company Claim letter
    08 II/AA 8276 W-590WW IREA Liens and Recovery Lien Amount letter
    08 II/AA 8277 W-590XX IREA Liens and Recovery Non-Assert letter
    08 II/AA 8278 W-590YY IREA Liens and Recovery Notice Of Lien
    08 II/AA 8279 W-590YY_1 IREA Liens and Recovery Notice Of Lien (amended)
    08 II/AA 7034 W-592K Division of Financial Review and Processing Worksheet
    08 II/AA 8232 W-593Y Applicant Referral to Bureau of Eligibility Verification - HV
    08 II/AA 6141 W-607A Request Identification card temporary Medicaid authorization
    08 II/AA 6378 W-607T Request for Common Benefit Identification Card
    08 II/AA 5979 W-608VV CBIC - Common Benefit ID Card Letter referring to
    08 II/AA 5984 W-62 Checklist for Case Transfer
    08 II/AA 6379 W-650A ACD Request for Cash Grant IVA Day Care Approval-Employ
    08 II/AA 6572 W-650C UCR Face Sheet and Request or Notification Authorization Form
    08 II/AA 1542 W-674A Record of Special Grant Cancellation & Duplication
    08 II/AA 1008 W-680 Out of NYC Birth or Death Verification Request
    08 II/AA 1628 W-680B Application-Job Profile
    08 II/AA 1668 W-680E Job Center Tracking System
    08 II/AA 1664 W-680F Applicant's Task List
    08 II/AA 1660 W-680H Employment Plan 35-50 Days to Employment
    08 II/AA 6431 W-680N DOL Referral Form
    08 II/AA 6437 W-680V Case Management Participation Profile
    08 II/AA 6119 W-680W Participant's Task List
    08 II/AA 1012 W-681 Out of NYC Marriage or Divorce Verification Request
    08 II/AA 1546 W-701 Request for Birth or Death Verification-NYC Dept Health
    08 II/AA 1550 W-701A Request for Certified Copy Of Birth or Death Certificate
    08 II/AA 6167 W-710-1 Unit Daily Record of Action Taken
    08 II/AA 7175 W-779A CWA Notice to OCSE Of Foster Child's Placement or Discharge
    08 II/AA 8264 W-820E Income Savings Requirement
    08 II/AA 8280 W-820F Income Savings Requirement (DHS Insert)
    08 II/AA 8281 W-820H Income Savings Requirement (ODVEIS Insert)
    08 II/AA 8282 W-820l Income Saving Requirement (HPD Insert)
    08 II/AA 7654 W-897B Client Rights or Respons or as Emergency Facility Resident
    08 II/AA 7660 W-897E Notice of Withdrawal of or App or for Program Admission
    08 II/AA 7006 W-897Q Rental Assistance Form 2 Excess Rent Maint. Of Residence
    08 II/AA 7646 W-897R Work Opp & Transitional Benefits/Income Disregard
    08 II/AA 7661 W-897U Case reassignment Letter
    08 II/AA 7655 W-897V Client satisfaction questionnaire EPU
    08 II/AA 7643 W-899E HASA Housing services-Statement of Non-participation
    08 II/AA 7644 W-899F HASA Services/Benefits-Statement of Non-participation
    08 II/AA 7659 W-899M Referral to OHMHS for Psychiatric Evaluation
    08 II/AA 7873 W-900A Verification of Homemaker Services Overtime Hours
    08 II/AA 7872 W-900P List of Homemaker tasks
    08 II/AA 7874 W-900T Application for Homemaking Services
    08 II/AA 8006 W-902G Request for Certified Copy of Birth Certificate
    08 II/AA 8005 W-902K HASA Referral to CASAC Form
    08 II/AA 8284 W-902T-Referral to FEC for Managed Care Form 9-28-10
    08 II/AA 8325 W-902V Notice of Intent to Reduce or Terminate Homemaker Services
    08 II/AA 8801 W-902V-a Notice of Decision Regarding Personal Care/Homemaking Services
    08 II/AA 6540 W-904D Notice of Claimant Enrollment from Income Maintenance Depart
    08 II/AA 6011 W-904E Eligibility Status of Addict or Alcoholic
    08 II/AA 7796 W-904E Eligibility Status of an individual with Substance Abuse
    08 II/AA 6148 W-904H RTC Residence Report
    08 II/AA 6382 W-906B Request for Third Party Health Insurance Information
    08 II/AA 6383 W-907HH Landlord Clearance
    08 II/AA 6384 W-907T Result of Enhance Quality Assurance Case Review
    08 II/AA 6385 W-908B Recertification Batch Data Entry Transmittal
    08 II/AA 6060 W-909 Interview Worksheet for Recertification
    08 II/AA 1470 W-909FF Recertification History Sheet
    08 II/AA 1526 W-909R W-272G Authorization to Cancel Scheduled Appointment
    08 II/AA 6023 W-909YY Face to Face Recertification Guide for required documentation
    08 II/AA 6263 W-912GG Audit of QRS Clerk
    08 II/AA 1474 W-912H Earned Income Monthly Report
    08 II/AA 6136 W-913 Request for Case Closing
    08 II/AA 6508 W-932 Baseline Clinical and Employability Assessment
    08 II/AA 6387 W-932A Alcoholism-Substance Abuse Treatment Prgrm Progress Rpt
    08 II/AA 6366 W2-112 Request for Reimbursement of Expenses to Attend Fair Hearing
    08 II/AA 7630 W34A CBCFA-Moving Expense - CBCFA
    08 II/AA 7621 W34A Itemized-Furniture Grant-CBCFA
    08 II/AA 6444 W904JJ Designation of FS Status of Foster Child
    08 II/AA 8090 WeCare Fair Hearing packet
    08 II/AA 8078 Wellness Plan Completed
    08 II/AA 8077 Wellness Plan Initiated
    08 II/AA 8079 Wellness Plan Supportive Documentation
    08 II/AA 8060 Wellness Rehabilitation Plan
    09 Match Info 6599 26 Memorandum - Match Material for Filing In Case Record
    09 Match Info 6596 36 Memorandum - ICP Recoupment or Overpayment Claim Calculation
    09 Match Info 6600 61 Memorandum - Match Material for Filing in case Record
    09 Match Info 6595 67 Memorandum - ICP Match on A Closed or Stopped Individual of Case
    09 Match Info 8188 AUTO REDUCTION MATCH FORM BNX027W2
    09 Match Info 7580 BNX 220R3 PA Bendex Error Out Match
    09 Match Info 6587 FCM210-R1 Match by other than childs name
    09 Match Info 6582 Foster Care - IM Child Match ICP
    09 Match Info 7596 HHC045R1 ICP- Health and Hospital Corporation Match Source Document
    09 Match Info 6620 HHC045R1 Report ICP Index - HHC Match
    09 Match Info 7982 HHCO45R1-Health and Hospitals Wage Match
    09 Match Info 6590 ICP 78 Memorandum - Computer Match Packets From
    09 Match Info 6585 JTP VS PA Match Records JTP665-R1
    09 Match Info 6048 M-3 Income Clearance Program Marriage Bureau Computer Match Worksheet
    09 Match Info 6601 Memorandum - Match Material for ISC Review & Appropriate Action
    09 Match Info 6604 NYC County Dept. of SS - Lottery Intercept Report
    09 Match Info 8248 PASDX Social Security Cintrax
    09 Match Info 6623 State Insurance Fund Match
    09 Match Info 6577 UIM371 Death Match-PA Health Dept Deceased Name Address Discrepancy
    09 Match Info 7180 UIM420-R1 PA/Correction Dept. Match
    09 Match Info 8296 UIM520- R1 = DEATH MATCH (NPA) WORKSHEET
    09 Match Info 6622 UIM915 State Insurance Fund Disability Benefits File
    09 Match Info 6667 W-138RR NPA Computer Match Worksheet or Closed Cases
    09 Match Info 6645 W-140KK Computer Match Unit DFRP Notification to IS or Job Centers
    09 Match Info 6586 W-25 Lottery Lump Sum History Sheet
    09 Match Info 6375 W-585F The City of NY HRA Elig Verification Review Program Undercare
    09 Match Info 7182 W-588H DFRP BFI Case Action Taken
    09 Match Info 7579 WINRO 742 PA Bendex Recoupment Only Match