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The purpose of this policy bulletin is to provide Workers at the Job Centers with information regarding the Universal Notification Form/Hand-Out to All Applicants for Welfare.
As of April 2007, the above form has been renamed Domestic Violence Information for all Temporary Assistance Applicants and it has been assigned form number LDSS-4905. The LDSS-4905 must be included in all Public Assistance (PA) application and recertification kits.
The Public Assistance Application Kit Forms list (M-90c) and the Public Assistance Recertification Kit Forms list (M-90d) have been revised to reflect this change.
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