(This Policy Bulletin Obsoletes PB 02-168-OPE, PB #04-173-OPE, PB #04-207-OPE)
The purpose of this policy bulletin is to inform staff that the New York State Office of Temporary and Disability Assistance's (OTDA) Manhattan Fair Hearing Office located at 330 West 34th Street is now closed. Consequently, the forms listed below have been revised to remove the above address from the forms' Fair Hearing section.
In addition, the link to OTDA's website, where applicants/participants may request a Fair Hearing online, has been revised to read as follows: http://www.otda.ny.gov/oah/forms.asp
• M-328h Notice of Intent to Reduce Cash Assistance and/or Food Stamp Benefits Due to Receipt of Social Security Benefits
• M-328h (S) Notice of Intent to Reduce Cash Assistance and/or Food Stamp Benefits Due to Receipt of Social Security Benefits (Spanish)
• M-858c Notice of Intent to Restrict Home Energy Allowance for Family Assistance Cases (Timely)
• M-858c (S) Notice of Intent to Restrict Home Energy Allowance for Family Assistance Cases (Timely) (Spanish)
• W-129EE Notice of Intent to Discontinue Food Stamp Benefits
• W-129EE (S) Notice of Intent to Discontinue Food Stamp Benefits (Spanish)
• W-134V Notice of Restoration of Food Stamp Benefits
• W-134V (S) Notice of Restoration of Food Stamp Benefits Spanish)
• W-145 Notice of Intent to Restrict Shelter Allowance (Timely)
• W-145 (S) Notice of Intent to Restrict Shelter Allowance Timely) (Spanish)
• W-145F Recoupment Worksheet to Determine Undue Hardship
• W-145F (S) Recoupment Worksheet to Determine Undue Hardship (Spanish)
• W-145HH Notice of Decision on Assistance to Meet an Immediate Need
• W-145HH (S) Notice of Decision on Assistance to Meet an Immediate Need (Spanish)
• W-146C Notice of Intent to Issue an Advance Allowance for Rent
• W-146C (S) Notice of Intent to Issue an Advance Allowance for Rent (Spanish)
• W-147C Notice of Action Taken on Underpayment Claim
• W-147C (S) Notice of Action Taken on Underpayment Claim Spanish)
• W-299G Notification of Continuing Medicaid Coverage for Children Under 19 Years of Age
• W-299G (S) Notification of Continuing Medicaid Coverage for Children Under 19 Years of Age (Spanish)
• W-500G Assignment Information Summary
• W-500G (S) Assignment Information Summary (Spanish)
• W-560CC Notice of Eligibility for Transitional Child Care Benefits
• W-560CC (S) Notice of Eligibility for Transitional Child Care Benefits (Spanish)
• W-637B Request for an Advance Payment to Prevent Eviction
• W-637B (S) Request for an Advance Payment to Prevent Eviction (Spanish)
• W-908T Notice of Recertification Appointment
• W-908T (S) Notice of Recertification Appointment (Spanish).
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