SI NY01801.106 (New York) SSA's Responsibility For Providing Verification

A. General

The F/S application and all available F/S documentation should be forwarded to the servicing F/S agency, within one workday after the day the F/S application is taken. The FO will mail the material using the SSA-4233 "Social Security Administration Transmittal For Food Stamp Applications". SSA interviewers will also advise the applicants that they will have to provide whatever documentation is needed by the F/S office. FOs should make clear that any further follow-up contacts for F/S's must be made with the F/S office and that the proofs required by SSA must be submitted to SSA separately. The SSA interviewer will give the applicant the following:

  1. The DSS-2642 - Documentation Requirements. Employees should complete the name and account number on the form and simply check-off the appropriate block(s). One copy is for the applicant and one copy should be mailed with the FS application.

  2. A self-addressed envelope, to the F/S office, in which the verification required for F/S should be mailed directly to the F/S office.

  3. The DSS-4148A - "What You Should Know About Your Rights and Responsibilities".

  4. The DSS-4148B - "What You Should Know About Social Services Programs".

B. Mailing the applications

After completing the food stamp application, the SSA interviewer should emphasize to the applicant that any additional contacts relevant to the F/S application must be made with the F/S agency. The SSA interviewer will mail the F/S application, the completed SSA-4233 "Social Security Transmittal For F/S Applications" (POMS SI 01801.400) and all other evidence to the local F/S office. In New York City only, the W-127N/P should accompany the F/S application.

1. New York State (Outside of New York City)

Offices should mail the completed forms to the F/S office in the county where the applicant resides. (See below for NYC cases.)

2. New York City

a. Pure SSI Household - One or Two Members

New York City has established one center in the City to handle the majority of F/S applications/recertifications. This office processes F/S applications/recertifications where the SSI household has one or two members. Therefore, any of these applications taken in New York City where the SSI household has one or two members should be mailed to: Food Stamp Program (Center F15) , P.O. Box C 9030, Brooklyn, New York 11202 (Actual address: 233 Schermerhorn St. Brooklyn, New York 11201). The general telephone number is: 718-722-4009. If there are more than two members in the SSI household, the application/recertification should be sent to the Food Stamp Center servicing the householder's zip code.

b. Drug Addicts and Alcoholics

All F/S applications/recertifications taken by authorized representatives for drug addicts or alcoholics in treatment centers should be mailed to:

Residential Treatment Center (F-52)
109 East 16 Street, First Floor
New York, New York 10003.

c. Homebound

If the FO receives any calls or inquiries regarding a homebound individual who wishes to apply for F/S's, they can be given the telephone number of the special homebound unit. The telephone numbers are: 1-718-722-8114, 8115, 8118 and 8119.

C. Ordering new applications (either the self-help kind or the kind completed by ssa employees), forms and envelopes

1. New York State (Outside of New York City)

Outside of New York City additional forms may be secured by contacting the local F/S office.

2. New York City

In New York City additional forms may be secured by contacting the New York Regional Office - Program Operations Center (POC) at (212) 264-4009.

3. Spanish Applications and Other Food Stamp Material

Any office that would like the Spanish version of any F/S forms should call the POC at the above number.

D. F/S materials for the reception area

As part of the agreement between SSA and the State of New York, SSA has agreed to keep certain F/S material in the reception area. Aside from posters and pamphlets, the following items should be kept as "self-help" items:

  • DSS-2921 and (DSS-2921NYC) - F/S Application.

  • DSS-1301 and (DSS-1301NYC) - How to Complete the F/S Application.

  • DSS-4148A - "What You Should Know About Your Rights and Responsibilities".

  • DSS-4148B - "What You Should