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PB Home  Back to OMM/OCFS/OTDA Materials: INFs Issued by OTDA    
Attached Document:
92_inf-30.pdf


OMM/OCFS/OTDA Materials: INFs Issued by OTDA

92 INF-30: Revision of Mandated "Public Assistance Recertification - Medical Assistance Status" (DSS-2114)
This INF introduces the revised mandated DSS-2114: "Public Assistance
Recertification - Medical Assistance Status". This form is used to notify
Public Assistance recipients that they are scheduled for a recertification
interview to determine whether they are still eligible for Public Assistance
and/or Medical Assistance. The DSS-2114 was formerly a single-ply notice
with English on the front and Spanish on the reverse. However, at the
request of local districts, it has been reformatted into a chemically
carbonless three-ply form and rewritten in plainer English.
 

 

Created: 10/28/2004
Updated: 10/28/2004