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Applications & Forms

Last Updated 5 sierpnia, 2022

Click on the links below to view and then print the forms.

NOTE: Some of the application(s) require additional information. Please review and complete the application(s) before submitting to an Agency.

Cash & Expenses

Cash Assistance
Instructions (Form 1301)
English | Spanish | Russian | Korean | Chinese | Haitian-Creole | Arabic | Bengali

Application Form (LDSS 2921)
English | Spanish | Russian Korean | Chinese | Haitian-Creole | Arabic | Bengali

Instructions for Recertification (Form 3113)
English | Spanish | Russian | Korean | Chinese | Haitian-Creole | Arabic | Bengali

Recertification (Form 3174)
English | Spanish | Russian | Korean | Chinese | Haitian-Creole | Arabic | Bengali

Cash Assistance Mail-in Recertification / Eligibility Questionnaire (Form M-327H)
English | Spanish | Russian | Korean | Chinese | Haitian-CreoleFrench | Arabic | Bengali | PolishUrdu

Child Tax Credit (CTC)
Form 1040 English

Form 1040NR
English 

Child and Dependent Care Tax Credit

Form 2441
English

Form 1040
English

Form 1040NR
English 

Earned Income Tax Credit (EITC)
Schedule EIC
English 

Form IT-215
English 

Worksheet C in the Instructions Form for IT-215
English 

Home Energy Assistance Program (HEAP) 

Family Services

Child Support Services
Application form with instructions
English
Other Child Support forms (for Custodial and Noncustodial Parents)

Family Planning Benefit Program (FPBP)
Application form with instructions
English | Spanish

Food

Pre-K for All (Pre-K)
Pre-K Finder 
Online Application

Health

Work

Supplemental Nutrition Assistance Program (SNAP)
Application and recertification forms with instructions
English | Spanish | RussianKorean | Chinese | Haitian-Creole | Arabic

Online Application

SNAP Periodic Report
English | Spanish | RussianKorean | Chinese | Haitian-Creole | Arabic  | Bangla
The SNAP Periodic Report Form asks SNAP recipients to inform HRA of any changes to their case. The report is due every six months after you start receiving or renew your benefits. If you do not submit it within six months, HRA will close your case.

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Medical Referral Form
English

School Food
Applications are no longer needed. Family income inquiry form is available to help schools receive funding.
Online Form

Housing

Senior Citizens Rent Increase Exemption (​SCRIE)
Initial Application Packet
English| Spanish | Russian | Korean | Chinese | Haitian-Creole | Arabic | BanglaFrench | Polish | Urdu

Renewal Universal Application Packet
English| Spanish | Russian | Korean | Chinese | Haitian-Creole | Arabic | BanglaFrench | Polish | Urdu

Short Form Renewal Application for longtime Rent Freeze program participants
English

Benefit Takeover Application
English

Disability Rent Increase Exemption (DRIE)
Initial Application Packet
English| Spanish | Russian | Korean | Chinese | Haitian-Creole | Arabic | BanglaFrench | Polish | Urdu

Renewal Universal Application Packet
English

Short Form Renewal Application for longtime Rent Freeze program participants
English

Benefit Takeover Application
English

Disabled Homeowners Exemption (DHE)

DHE Exemption Online Application

Initial Application form with instructions
English| Spanish | Russian | Korean | Chinese | Haitian-Creole | Arabic | BanglaFrench | Polish | Urdu

Senior Citizen Homeowners’ Exemption (SCHE)

SCHE Exemption Online Application

Initial Application form with instructions
English| Spanish | Russian | Korean | Chinese | Haitian-Creole | Arabic | BanglaFrench | Polish| Urdu

Veterans’ Property Tax Exemption
English

School Tax Relief Program (STAR)
Online Application

STAR to ESTAR application form

Online Application for Co-ops

Online Application

English

STAR Benefit Restoration application form
Online Application

Online Application for Co-ops

English

Summer Youth Employment Program (SYEP)
Online application

NYCHA Resident Economic Empowerment and Sustainability (REES)
Customer Information Form
English

Senior Employment Services (SES)
English

NYS Unemployment Insurance
Online application

Workforce1
Explore Job Openings
Register to attend a recruitment event

Last Updated 5 sierpnia, 2022