Office of Temporary and Disability Assistance

David A. Hansell, Commissioner

OTDA Home → News & Public Information → Common Forms and Applications

NYS OTDA Common Forms and Applications

The following forms and applications are available for your usage.

To view these forms you will need the Adobe Acrobat Reader, available free at http://www.adobe.com/products/acrobat/. If the format interferes with your ability to access any of the information, please e-mail the OTDA Public Information Officer at nyspio@otda.state.ny.us.

Common Application for Temporary Assistance (TA), Medical Assistance (MA), Food Stamp Benefits (FS), and Services (S) including Foster Care (FC) and Child Care Assistance (CC):

Recertification Form for Temporary Assistance (TA), Medical Assistance (MA), Medicare Savings Program (MSP), and Food Stamp Benefits (FS):

Food Stamps Benefits Application & Instructions for Completion:

Request for Replacement of Food Purchased with Food Stamps Benefits:

Safety Net Assistance (SNA) Application Supplement:

Application for Child Support Services:

TANF Services Certification:

Youth Application for TANF Services: