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1 August 7, 2014 Ms. Shelley Sabo, Executive Director New York Center for Assisted Living 33 Elk Street, Suite 300 Albany, New York Dear Ms. Sabo: The purpose of this letter is to provide you and your membership with an update on the status of New York State s takeover of the administration of the State Supplement Program (SSP), and to share with you samples of the letters being sent to SSP recipients informing them of this change. As discussed at your audio conference in May, New York State (NYS) will assume responsibility for the administration of the SSI State Supplement Program (SSP) on October 1, At that time, this Office, rather than the Social Security Administration (SSA), will issue the State portion of the SSI benefit. This means that instead of receiving one benefit each month that includes federal and State funds, these recipients will receive two payments each month one from SSA and one from NYS. It is important to note that the total benefit will not change. A summary of the changes that will result from the transition is enclosed. On August 4, 2014, OTDA began mailing letters notifying SSI/SSP recipients of this change. These letters are being mailed on a staggered basis through the end of next week. Samples of the OTDA letters are enclosed. A separate notice from SSA will be sent to these same recipients later this month. The SSP Customer Support Center has been established and is available to assist recipients and other stakeholders. The toll-free number, , will operate Monday through Friday from 8:30 AM to 4:45 PM. All inquiries should be directed to the toll free number. More information about the New York State Supplement Program and the transition from federal to State administration can be found at This information will be updated throughout the transition process. We appreciate your assistance during the planning process and look forward to continuing to work with you. If you have questions or would like further information, please contact Paula Cook at Paula.Cook@otda.ny.gov. Sincerely, Enclosures /s/ JH 8/7/14 John Haley Director SSI State Supplement Program Bureau cc: Paula Cook OTDA-L1 providing temporary assistance for permanent change

2 - 2 - Questions and Answers for SSI Recipients What is an SSP Payment? The Social Security Administration (SSA) currently sends you a monthly payment, part or all of which comes from money that New York State (NYS) provides. This is called the SSI State Supplement Program (SSP) payment. When SSA also makes a federal Supplemental Security Income (SSI) payment to you, they add these two amounts together, and they send to you as one payment. What will change on October 1st? If you receive both SSI and SSP you will receive two payments, one from SSA and one from NYS. If you receive only SSP you will receive one payment from NYS. Will I continue to receive the same benefit amount? Yes. NYS sending you your SSP payment will not change the total amount you receive. Do I need to do anything? No, there is no need for you to do anything. Will I get information from SSA before October 1st? Yes. You will receive a notice from SSA at the beginning of September. This notice will tell you that your SSI payment is changing. This just means that the Social Security Administration will not be sending the SSP portion of your monthly payments starting on October, but NYS will be. How will I be able to identify my SSP direct deposit payment on my bank statement? A notation will appear with an SSP direct deposit credit on your bank statement. If you receive a paper check in the mail, your SSP check will come from New York State. What if I have a Representative Payee? If you have a Representative Payee for your SSI benefits, that person will automatically receive your state SSP benefits and notices on your behalf. What if I have questions? If you have any questions, please call the New York SSP Customer Support Center at TQA(2/14) OTDA-L1 providing temporary assistance for permanent change

3 - 3 - Preguntas y Respuestas para Beneficiarios del SSI Qué es un pago del Programa de Suplemento Estatal (SSP)? La Administración del Seguro Social (SSA) actualmente le envía a usted un pago mensualmente, una parte o la totalidad de ese pago proviene del Estado de Nueva York (NYS). A esto se le llama pago de Suplemento Estatal (SSP) al SSI. Cuando la Administración del Seguro Social (SSA) también le hace a usted un pago de Seguridad de Ingreso Suplementario (SSI) federal, ellos suman las dos cantidades y se lo envían a usted como un solo pago. Qué cambios se harán el 1º de octubre? Si recibe ambos pagos, SSI y Suplemento Estatal (SSP), usted recibirá dos pagos: uno de la Administración del Seguro Social (SSA) y otro del Estado de Nueva York. Si solamente recibe el Suplemento Estatal (SSP), recibirá un pago del Estado de Nueva York. Continuaré recibiendo el mismo monto de beneficios? Sí. El Estado de Nueva York le enviará su pago de Suplemento Estatal (SSP) y no cambiará el monto total que usted recibe. Tengo que hacer algo? No, no tiene que hacer nada Recibiré información de la Administración del Seguro Social (SSA) antes del 1º de octubre? Sí. Usted recibirá una notificación de la Administración del Seguro Social a principios de septiembre. En esa notificación se le informará sobre el cambio del pago del SSI. Esto quiere decir que a partir de octubre, la Administración del Seguro Social no le enviará la porción del Suplemento Estatal (SSP) de sus pagos mensuales, sino que lo hará el Estado de Nueva York. Cómo podré identificar en mi estado de cuenta mi pago de Suplemento Estatal (SSP) de depósito directo? En su estado de cuenta bancaria aparecerá una nota con el abono del depósito directo del Suplemento Estatal (SSP). Si usted recibe un cheque por correo, el cheque del Suplemento Estatal (SSP) lo enviará el Estado de Nueva York. Y si tengo un Representante del Beneficiario? Si tiene un representante del beneficiario para sus beneficios de Seguridad de Ingreso Suplementario (SSI), esa persona recibirá automáticamente sus beneficios y notificaciones del Programa de Suplemento Estatal (SSP) en su nombre. Qué debe hacer si todavía tiene preguntas? Si tiene preguntas, llame a la línea de servicio al cliente del Programa de Suplemento del Estado de Nueva York (New York State SSP) al Form # (Rev. Date) OTDA-L1 providing temporary assistance for permanent change

4 Transition of the Administration of the SSI State Supplement Program (SSP) Summary of Changes 8/7/2014 New York State Office of Temporary and Disability Assistance

5 Summary of Changes Prior to October 1, 2014 Effective October 1, 2014 APPLICATION AND ELIGIBILITY PROCESS Application is filed with the Social Security Administration (SSA). Application is filed with the Social Security Administration (SSA) and continues to serve as the application for the State Supplement Program (SSP). There is no separate application for the SSP. Eligibility requirements for SSP remain the same. An individual must either be eligible for SSI or ineligible for SSI due to income that is still within State eligibility standards. SSA determines eligibility and benefit amount for both Supplement Security Income (SSI) and the New York State Supplement Program (SSP). SSA performs a separate eligibility calculation for SSP if the applicant is ineligible for SSI benefits due to excess income and will issue just SSP benefits if the applicant is eligible. SSA determines eligibility and benefit amount for SSI but does NOT determine SSP eligibility or benefit level. SSA transmits information on both SSI eligible recipients and on applicants denied SSI due to excess income to New York State via the State Data Exchange (SDX). OTDA SSP will perform a separate calculation for those applicants over the SSI income eligibility standards to determine if the applicant is income eligible for SSP-only benefits. SSA determines the recipient s New York State Living Arrangement (SLA) as part of the eligibility process. 1 SSA will not determine the SLA. OTDA SSP will be responsible and will use a variety of information sources (i.e., SDX, the Welfare Management System (WMS), Congregate Care

6 Summary of Changes Prior to October 1, 2014 Effective October 1, 2014 Directory, the applicant/recipient) to determine the SLA. SSI and /or SSP benefits generally begin in the month following the month in which the application was filed. SSP benefits generally begin in the month following the month in which the application was filed. BENEFIT AMOUNTS SSA issues one monthly payment that includes both the SSI and SSP benefit or, if the recipient is eligible only for SSP, includes only the SSP benefit. Two monthly payments will be issued to recipients receiving both SSI and SSP benefits. SSA will issue the federal SSI benefit and NYS will issue the SSP benefit separately. SSP-only benefits will be issued solely by NYS. The total benefit amount received by the recipient remains the same. 2

7 Summary of Changes Prior to October 1, 2014 Effective October 1, 2014 PAYMENT METHODS SSA issues benefits via direct deposit into a savings or checking account, onto a Direct Express card, or by check if the recipient has requested a waiver and received approval of the waiver from SSA. OTDA SSP will issue the SSP benefit in the same manner as the SSI benefit for those recipients receiving both SSI and SSP. OTDA SSP will continue to issue SSP-only benefits in the same manner that SSA used for those SSP-only recipients who are in receipt of benefits before the transition. SSP-only recipients who become eligible after October 1 may choose the method of payment, but direct deposit is strongly encouraged. No waiver is required to receive payments by check. In most cases, a check is automatically issued if the direct deposit fails in any given month. BANKING INFORMATION Banking information and direct deposit forms sent to SSA are used to issue and deposit both SSI and SSP benefits. Banking information provided to SSA will be utilized for SSP benefits for those recipients receiving both SSI and SSP. For SSP-only recipients who become eligible after October 1, and for any SSP-only recipient who decides to change banking options, banking information must be submitted directly to OTDA SSP. 3

8 Summary of Changes Prior to October 1, 2014 Effective October 1, 2014 BENEFIT ISSUANCE DATES Benefits for recipients in receipt of SSI and/or SSP are issued on the first of each month or on the preceding business day if the first falls on Saturday, Sunday or a holiday. SSP benefits will be issued on the first of each month or on the preceding business day if the first falls on Saturday, Sunday or a holiday. RECOVERY OF OVERPAYMENTS CORRECTING UNDERPAYMENTS DISABILITY PROCESS SSA identifies and recovers overpayments for both SSI and SSP. SSA identifies and corrects underpayments for both SSI and SSP. SSA determines disability for all SSI and SSP-Only recipients. SSA identifies and recovers overpayments using federal rules for SSI only. OTDA SSP identifies and recovers overpayments for SSP. SSA identifies and corrects underpayments for SSI only. OTDA SSP identifies and corrects underpayments for SSP. SSA will continue to conduct disability determinations as part of the SSI application process. OTDA SSP will accept all disability determinations made by SSA. In cases where an applicant is over income for SSI and a disability determination is required, OTDA will conduct the disability determination for those applicants whose income is within SSP limits. 4

9 Summary of Changes Prior to October 1, 2014 Effective October 1, 2014 REPORTING CHANGES All changes, including those for SSP-only recipients, are reported to and managed by SSA. Recipients of both SSI and SSP will continue to report changes to SSA, who will pass these changes to OTDA SSP via the SDX. Congregate Care providers must are asked to report admissions and discharges of SSI recipients to both SSA and OTDA. SSP-only recipients report all changes to OTDA SSP. PAYEES SSA rules for Representative Payees are followed for both SSI and SSP. Representative Payees manage both SSI and SSP benefits. Representative Payees may be appointed by SSA due to recipient inability to manage funds and may be eligible to receive fees for services. OTDA SSP has a similar process for third party payees entitled Designated Representatives. OTDA SSP will automatically accept all SSA Representative Payees and the SSA Representative Payee will become the Designated Representative for the SSP payments. A recipient in receipt of both SSI and SSP may only have one payee. 5

10 Summary of Changes Prior to October 1, 2014 Effective October 1, 2014 PAYEES, CONT D All changes for Representative Payees are made through SSA. A recipient receiving both SSI and SSP with an existing SSA Representative Payee may only change the Representative Payee through SSA and may not have different payee for SSP. SSI recipients who wish to designate a payee must make the request to SSA. OTDA SSP will not accept requests for payees for SSP for recipients who also receive SSI. SSP-only recipients may change their Designated Representative through OTDA SSP. SSA has organizational and individual representative payees. Payees must provide SSA with an annual accounting of funds. SSP does not have organizational Designated Representatives. SSP does not have an annual accounting requirement for SSP only funds but all SSP Designated Representative Payees are subject to audit as necessary. Other changes: Designated Representatives are voluntary for most SSP-only recipients. SSP does not have fee provisions for services provided by Representative Payees or Designated Representatives. 6

11 Summary of Changes Prior to October 1, 2014 Effective October 1, 2014 An SSP-only recipient may grant different levels of authority to the Designated Representative. These are: payee, receive and provide information, and Fair Hearing representative. APPEALS All appeals are handled by SSA using federal rules. Hearings on federal determinations will be handled by SSA. Hearings on OTDA SSP determinations will be handled by the NYS Office of Administrative Hearings (OAH) in accordance with OTDA regulations and procedures. TEMPORARY HOSPITAL STAYS Recipient or congregate care provider notifies SSA of an individual s temporary transfer to a hospital. SSA continues to pay the SSI/SSP or SSP-Only benefit for up to 90 days to retain the recipient s bed. Recipient or provider notifies SSA and OTDA SSP of an individual s temporary transfer to a hospital. SSA continues to pay the SSI benefit and NYS will continue to pay the SSP benefit for up to 90 days to retain the recipient s bed. 7

12 NYS OTDA STATE SUPPLEMENT PROGRAM PO BOX 1740 ALBANY, NEW YORK New York State Office of Temporary and Disability Assistance John Q Public 123 Main Street Any Town, NY SAMPLE Person ID Number: The purpose of this letter is to inform you of changes to the New York State Supplement Program (SSP) beginning in October The monthly Supplemental Security Income (SSI) benefit which you currently receive from the Social Security Administration (SSA) includes both federal funds and a monthly New York State supplement. Beginning in October 2014 your same monthly SSI benefit will be issued as two separate payments. The federal government will issue the federal portion and New York State will issue the SSP portion. Your SSP payment will be made on or before the first day of each month. This will not change your eligibility, the way you get your benefits, or the total amount of your monthly benefit. Please read the Question and Answer sheet which provides more information about this change. If you have any additional questions please call the New York State SSP Customer Support Center at or visit the New York State website at If you would like information about other available human services benefit programs in New York State, please visit If you are blind or visually impaired, and are having difficulty reading this notice, please contact us to learn about other formats by which you can receive notices from us. TSSIP(2/14)

13 Questions and Answers for SSI Recipients What is an SSP Payment? The Social Security Administration (SSA) currently sends you a monthly payment, part or all of which comes from money that New York State (NYS) provides. This is called the SSI State Supplement Program (SSP) payment. When SSA also makes a federal Supplemental Security Income (SSI) payment to you, they add these two amounts together, and they send to you as one payment. What will change on October 1st? If you receive both SSI and SSP you will receive two payments, one from SSA and one from NYS. If you receive only SSP you will receive one payment from NYS. Will I continue to receive the same benefit amount? Yes. NYS sending you your SSP payment will not change the total amount you receive. Do I need to do anything? No, there is no need for you to do anything. Will I get information from SSA before October 1st? Yes. You will receive a notice from SSA. This notice will tell you that your SSI payment is changing. This just means that the Social Security Administration will not be sending the SSP portion of your monthly payments starting on October, but NYS will be. How will I be able to identify my SSP direct deposit payment on my bank statement? A notation will appear with an SSP direct deposit credit on your bank statement. If you receive a paper check in the mail, your SSP check will come from New York State. What if I have a Representative Payee? If you have a Representative Payee for your SSI benefits, that person will automatically receive your state SSP benefits and notices on your behalf. What if I have questions? If you have any questions, please call the New York SSP Customer Support Center at TQA(2/14)

14 NYS OTDA STATE SUPPLEMENT PROGRAM PO BOX 1740 ALBANY, NEW YORK New York State Office of Temporary and Disability Assistance John Q Public 123 Main Street Any Town, NY SAMPLE No de identificación: El propósito de la presente es para informarle de las modificaciones que se implementarán a partir de octubre de 2014, en el Programa de Suplemento del Estado de Nueva York (New York State Supplement Program SSP, por sus siglas en inglés). El subsidio de Seguridad de Ingreso Suplementario (SSI) que usted actualmente recibe de la Administración del Seguro Social (SSA, siglas en inglés), se conforma de fondos federales y del suplemento mensual del Estado de Nueva York. A partir de octubre de 2014, su subsidio mensual de SSI será remitido en dos pagos por separado. El gobierno federal remitirá la porción federal y el Estado de Nueva York remitirá la porción del Estado. Su pago del Programa de Suplemento del Estado de Nueva York, (SSP) se hará el día primero de cada mes o antes. Esto no afectará de ninguna manera su habilitación para recibir el subsidio; o la manera como recibe sus subsidios; o el monto total mensual de su subsidio. Sírvase leer la hoja adjunta de preguntas y respuestas en la cual encontrará más información sobre este cambio. Si tiene más preguntas, sírvase llamar gratis a la línea de servicio al cliente del Programa de Suplemento Estatal del Estado de Nueva York (New York State SSP) al ; o ingrese a la página web del Estado de Nueva York Si desea más información sobre otros programas de servicios humanos disponibles en el Estado de Nueva York, ingrese a la página web Si es ciego o tiene impedimentos visuales, y por consiguiente tiene dificultad para leer esta notificación, sírvase comunicarse con nosotros para dejarle saber sobre las otras opciones disponibles de envío de notificaciones. TSSIP(2/14) SP

15 Preguntas y Respuestas para Beneficiarios del SSI Qué es un pago del Programa de Suplemento Estatal (SSP)? La Administración del Seguro Social (SSA) actualmente le envía a usted un pago mensualmente, una parte o la totalidad de ese pago proviene del Estado de Nueva York (NYS). A esto se le llama pago de Suplemento Estatal (SSP) al SSI. Cuando la Administración del Seguro Social (SSA) también le hace a usted un pago de Seguridad de Ingreso Suplementario (SSI) federal, ellos suman las dos cantidades y se lo envían a usted como un solo pago. Qué cambios se harán el 1º de octubre? Si recibe ambos pagos, SSI y Suplemento Estatal (SSP), usted recibirá dos pagos: uno de la Administración del Seguro Social (SSA) y otro del Estado de Nueva York. Si solamente recibe el Suplemento Estatal (SSP), recibirá un pago del Estado de Nueva York. Continuaré recibiendo el mismo monto de beneficios? Sí. El Estado de Nueva York le enviará su pago de Suplemento Estatal (SSP) y no cambiará el monto total que usted recibe. Tengo que hacer algo? No, no tiene que hacer nada Recibiré información de la Administración del Seguro Social (SSA) antes del 1º de octubre? Sí. Usted recibirá una notificación de la Administración del Seguro Social. En esa notificación se le informará sobre el cambio del pago del SSI. Esto quiere decir que a partir de octubre, la Administración del Seguro Social no le enviará la porción del Suplemento Estatal (SSP) de sus pagos mensuales, sino que lo hará el Estado de Nueva York. Cómo podré identificar en mi estado de cuenta mi pago de Suplemento Estatal (SSP) de depósito directo? En su estado de cuenta bancaria aparecerá una nota con el abono del depósito directo del Suplemento Estatal (SSP). Si usted recibe un cheque por correo, el cheque del Suplemento Estatal (SSP) lo enviará el Estado de Nueva York. Y si tengo un Representante del Beneficiario? Si tiene un representante del beneficiario para sus beneficios de Seguridad de Ingreso Suplementario (SSI), esa persona recibirá automáticamente sus beneficios y notificaciones del Programa de Suplemento Estatal (SSP) en su nombre. Qué debe hacer si todavía tiene preguntas? Si tiene preguntas, llame a la línea de servicio al cliente del Programa de Suplemento del Estado de Nueva York (New York State SSP) al TQA(2/14) SP

16 NYS OTDA STATE SUPPLEMENT PROGRAM PO BOX 1740 ALBANY, NEW YORK New York State Office of Temporary and Disability Assistance John Q Public 123 Main Street Any Town, NY SAMPLE Person ID Number: Your monthly Supplemental Security Income (SSI) benefit that is issued by the Social Security Administration (SSA) is made up of State funds paid by New York State under the State Supplement Program (SSP) administered by SSA. Beginning in October 2014, New York State will be sending you your monthly benefit rather than SSA. Your SSP payment will be made on or before the first day of each month. This will not change your eligibility, the way you get your benefits, or the amount of your total monthly benefit. Please read the Question and Answer sheet which provides more information about this change. If you have any additional questions please call the New York State SSP Customer Support Center toll free at or visit the New York State website at If you would like information about other available human services benefit programs in New York State, please visit If you are blind or visually impaired, and are having difficulty reading this notice, please contact us to learn about other formats by which you can receive notices from us. TSSP(2/14)

17 Questions and Answers for SSI Recipients What is an SSP Payment? The Social Security Administration (SSA) currently sends you a monthly payment, part or all of which comes from money that New York State (NYS) provides. This is called the SSI State Supplement Program (SSP) payment. When SSA also makes a federal Supplemental Security Income (SSI) payment to you, they add these two amounts together, and they send to you as one payment. What will change on October 1st? If you receive both SSI and SSP you will receive two payments, one from SSA and one from NYS. If you receive only SSP you will receive one payment from NYS. Will I continue to receive the same benefit amount? Yes. NYS sending you your SSP payment will not change the total amount you receive. Do I need to do anything? No, there is no need for you to do anything. Will I get information from SSA before October 1st? Yes. You will receive a notice from SSA. This notice will tell you that your SSI payment is changing. This just means that the Social Security Administration will not be sending the SSP portion of your monthly payments starting on October, but NYS will be. How will I be able to identify my SSP direct deposit payment on my bank statement? A notation will appear with an SSP direct deposit credit on your bank statement. If you receive a paper check in the mail, your SSP check will come from New York State. What if I have a Representative Payee? If you have a Representative Payee for your SSI benefits, that person will automatically receive your state SSP benefits and notices on your behalf. What if I have questions? If you have any questions, please call the New York SSP Customer Support Center at TQA(2/14)

18 NYS OTDA STATE SUPPLEMENT PROGRAM PO BOX 1740 ALBANY, NEW YORK New York State Office of Temporary and Disability Assistance John Q Public 123 Main Street Any Town, NY SAMPLE No de identificación: El subsidio mensual que usted recibe denominado Seguridad de Ingreso Suplementario (SSI), el cual es otorgado por la Administración del Seguro Social (SSA), se compone de fondos estatales que paga el Estado de Nueva York bajo el Programa de Suplemento Estatal (SSP). Este programa es dirigido por la Administración del Seguro Social (SSA). Comenzando en octubre de 2014, el Estado de Nueva York, en lugar de la Administración del Seguro Social (SSA), empezará a enviarle su subsidio mensual. El pago de su subsidio de Suplemento Estatal (SSP) se hará el primero de cada mes o antes. Esta transición no cambia su habilitación, la manera como recibe sus subsidios o el monto total mensual de su subsidio. Sírvase leer la hoja adjunta de preguntas y respuestas en la cual encontrará más información sobre este cambio. Si tiene más preguntas, sírvase llamar gratis a la línea de servicio al cliente del Programa de Suplemento del Estado de Nueva York (New York State- SSP) al o ingrese a la página web Si desea más información sobre otros programas de servicios humanos disponibles en el Estado de Nueva York, ingrese a la página web Si es ciego o tiene impedimentos visuales y por consiguiente tiene dificultad para leer esta notificación, sírvase comunicarse con nosotros para dejarle saber sobre las otras opciones disponibles de envío de notificaciones. TSSP(2/14) SP

19 Preguntas y Respuestas para Beneficiarios del SSI Qué es un pago del Programa de Suplemento Estatal (SSP)? La Administración del Seguro Social (SSA) actualmente le envía a usted un pago mensualmente, una parte o la totalidad de ese pago proviene del Estado de Nueva York (NYS). A esto se le llama pago de Suplemento Estatal (SSP) al SSI. Cuando la Administración del Seguro Social (SSA) también le hace a usted un pago de Seguridad de Ingreso Suplementario (SSI) federal, ellos suman las dos cantidades y se lo envían a usted como un solo pago. Qué cambios se harán el 1º de octubre? Si recibe ambos pagos, SSI y Suplemento Estatal (SSP), usted recibirá dos pagos: uno de la Administración del Seguro Social (SSA) y otro del Estado de Nueva York. Si solamente recibe el Suplemento Estatal (SSP), recibirá un pago del Estado de Nueva York. Continuaré recibiendo el mismo monto de beneficios? Sí. El Estado de Nueva York le enviará su pago de Suplemento Estatal (SSP) y no cambiará el monto total que usted recibe. Tengo que hacer algo? No, no tiene que hacer nada Recibiré información de la Administración del Seguro Social (SSA) antes del 1º de octubre? Sí. Usted recibirá una notificación de la Administración del Seguro Social. En esa notificación se le informará sobre el cambio del pago del SSI. Esto quiere decir que a partir de octubre, la Administración del Seguro Social no le enviará la porción del Suplemento Estatal (SSP) de sus pagos mensuales, sino que lo hará el Estado de Nueva York. Cómo podré identificar en mi estado de cuenta mi pago de Suplemento Estatal (SSP) de depósito directo? En su estado de cuenta bancaria aparecerá una nota con el abono del depósito directo del Suplemento Estatal (SSP). Si usted recibe un cheque por correo, el cheque del Suplemento Estatal (SSP) lo enviará el Estado de Nueva York. Y si tengo un Representante del Beneficiario? Si tiene un representante del beneficiario para sus beneficios de Seguridad de Ingreso Suplementario (SSI), esa persona recibirá automáticamente sus beneficios y notificaciones del Programa de Suplemento Estatal (SSP) en su nombre. Qué debe hacer si todavía tiene preguntas? Si tiene preguntas, llame a la línea de servicio al cliente del Programa de Suplemento del Estado de Nueva York (New York State SSP) al TQA(2/14) SP

SAMPLE. Person ID Number:

SAMPLE. Person ID Number: NYS OTDA STATE SUPPLEMENT PROGRAM PO BOX 1740 ALBANY, NEW YORK 12201 New York State Office of Temporary and Disability Assistance John Q Public 123 Main Street Any Town, NY 12345 SAMPLE Person ID Number:

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