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249
![Form HCSP-M11Q "Medical Request for Home Care" - New York City](https://data.templateroller.com/pdf_docs_html/1999/19995/1999521/form-hcsp-m11q-medical-request-for-home-care-new-york-city.png "Form HCSP-M11Q "Medical Request for Home Care" - New York City")
Form HCSP-M11Q "Medical Request for Home Care" - New York City
Size: 85 KB
4 pages
This is a document that is used in the state of New York to apply for personal home care and contains information regarding the patient's medical condition.
![Form W-147Q "Primary Tenant's Statement Regarding Occupancy of Secondary Tenant" - New York City](https://data.templateroller.com/pdf_docs_html/1999/19996/1999671/form-w-147q-primary-tenant-s-statement-regarding-occupancy-of-secondary-tenant-new-york-city.png "Form W-147Q "Primary Tenant's Statement Regarding Occupancy of Secondary Tenant" - New York City")
Form W-147Q "Primary Tenant's Statement Regarding Occupancy of Secondary Tenant" - New York City
Size: 107 KB
1 page
This document is completed by a tenant and confirms that other tenants in the lease share New York City residence with them.
![Form OCS-1 "Authorization to Release Case Information" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20718/2071811/form-ocs-1-authorization-to-release-case-information-new-york-city.png "Form OCS-1 "Authorization to Release Case Information" - New York City")
![Form 6 "Addition of a Household Member" - New York City](https://data.templateroller.com/pdf_docs_html/2279/22798/2279802/form-6-addition-of-a-household-member-new-york-city.png "Form 6 "Addition of a Household Member" - New York City")
![Form 5 "Declaration of Un-reimbursed Disability Expenses" - New York City](https://data.templateroller.com/pdf_docs_html/2279/22798/2279803/form-5-declaration-of-un-reimbursed-disability-expenses-new-york-city.png "Form 5 "Declaration of Un-reimbursed Disability Expenses" - New York City")
![Form 4 "Declaration of Un-reimbursed Medical and Pharmacy Expenses" - New York City](https://data.templateroller.com/pdf_docs_html/2279/22798/2279805/form-4-declaration-of-un-reimbursed-medical-and-pharmacy-expenses-new-york-city.png "Form 4 "Declaration of Un-reimbursed Medical and Pharmacy Expenses" - New York City")
![Form 8 "Declaration of Citizenship Status" - New York City](https://data.templateroller.com/pdf_docs_html/2279/22798/2279804/form-8-declaration-of-citizenship-status-new-york-city.png "Form 8 "Declaration of Citizenship Status" - New York City")
![Form 7 "Removal of Household Member" - New York City](https://data.templateroller.com/pdf_docs_html/2279/22798/2279806/form-7-removal-of-household-member-new-york-city.png "Form 7 "Removal of Household Member" - New York City")
![Form DSS-8Q "Landlord Utility Information" - New York City](https://data.templateroller.com/pdf_docs_html/2439/24391/2439179/form-dss-8q-landlord-utility-information-new-york-city.png "Form DSS-8Q "Landlord Utility Information" - New York City")
![Form DSS-35 "Dss Rent Comparable Form" - New York City](https://data.templateroller.com/pdf_docs_html/2439/24391/2439180/form-dss-35-dss-rent-comparable-form-new-york-city.png "Form DSS-35 "Dss Rent Comparable Form" - New York City")
![Form DSS-8G "Cityfheps Landlord Statement of Understanding - Room and Sro Rentals" - New York City](https://data.templateroller.com/pdf_docs_html/2439/24391/2439178/form-dss-8g-cityfheps-landlord-statement-of-understanding-room-and-sro-rentals-new-york-city.png "Form DSS-8G "Cityfheps Landlord Statement of Understanding - Room and Sro Rentals" - New York City")
![Form DSS-8D "Room Rental Allocation Form" - New York City](https://data.templateroller.com/pdf_docs_html/2213/22138/2213857/form-dss-8d-room-rental-allocation-form-new-york-city.png "Form DSS-8D "Room Rental Allocation Form" - New York City")
![Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City](https://data.templateroller.com/pdf_docs_html/2238/22388/2238872/form-dss-7q-application-for-cityfheps-apartments-and-single-room-occupancy-units-new-york-city.png "Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City")
![Form DSS-8F "Cityfheps Landlord Information Form - Apartment Rentals" - New York City](https://data.templateroller.com/pdf_docs_html/2238/22388/2238876/form-dss-8f-cityfheps-landlord-information-form-apartment-rentals-new-york-city.png "Form DSS-8F "Cityfheps Landlord Information Form - Apartment Rentals" - New York City")
![Form DSS-8I "Cityfheps Packet Cover Sheet - Community" - New York City](https://data.templateroller.com/pdf_docs_html/2238/22388/2238871/form-dss-8i-cityfheps-packet-cover-sheet-community-new-york-city.png "Form DSS-8I "Cityfheps Packet Cover Sheet - Community" - New York City")
![Form DSS-8H "Cityfheps Packet Cover Sheet - Shelter" - New York City](https://data.templateroller.com/pdf_docs_html/2238/22388/2238870/form-dss-8h-cityfheps-packet-cover-sheet-shelter-new-york-city.png "Form DSS-8H "Cityfheps Packet Cover Sheet - Shelter" - New York City")
![Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Korean)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193168/form-dss-7q-application-for-cityfheps-apartments-and-single-room-occupancy-units-new-york-city-korean.png "Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Korean)")
![Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Haitian Creole)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193164/form-dss-7q-application-for-cityfheps-apartments-and-single-room-occupancy-units-new-york-city-haitian-creole.png "Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Haitian Creole)")
![Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Bengali)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193166/form-dss-7q-application-for-cityfheps-apartments-and-single-room-occupancy-units-new-york-city-bengali.png "Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Bengali)")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (French)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193171/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-french.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (French)")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Haitian Creole)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193172/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-haitian-creole.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Haitian Creole)")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Korean)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193176/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-korean.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Korean)")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Chinese)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193174/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-chinese.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Chinese)")
![Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Russian)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193177/form-dss-7q-application-for-cityfheps-apartments-and-single-room-occupancy-units-new-york-city-russian.png "Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Russian)")
![Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (French)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193173/form-dss-7q-application-for-cityfheps-apartments-and-single-room-occupancy-units-new-york-city-french.png "Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (French)")
![Formulario DSS-7O "Solicitud De Cityfheps (Solo Para Habitaciones)" - New York City (Spanish)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193167/formulario-dss-7o-solicitud-de-cityfheps-solo-para-habitaciones-new-york-city-spanish.png "Formulario DSS-7O "Solicitud De Cityfheps (Solo Para Habitaciones)" - New York City (Spanish)")
![Formulario DSS-7Q "Solicitud Para Cityfheps (Para Apartamentos Y Habitaciones De Ocupacion Individual)" - New York City (Spanish)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193163/formulario-dss-7q-solicitud-para-cityfheps-para-apartamentos-y-habitaciones-de-ocupacion-individual-new-york-city-spanish.png "Formulario DSS-7Q "Solicitud Para Cityfheps (Para Apartamentos Y Habitaciones De Ocupacion Individual)" - New York City (Spanish)")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Russian)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193169/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-russian.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Russian)")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City](https://data.templateroller.com/pdf_docs_html/2193/21931/2193165/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City")
![Form DSS-8E "Cityfheps Verification of Eligibility" - New York City](https://data.templateroller.com/pdf_docs_html/2193/21931/2193162/form-dss-8e-cityfheps-verification-of-eligibility-new-york-city.png "Form DSS-8E "Cityfheps Verification of Eligibility" - New York City")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Bengali)](https://data.templateroller.com/pdf_docs_html/2193/21931/2193170/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-bengali.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Bengali)")
![Form SNT-12 "Supplemental Needs Trust Accounting" - New York City](https://data.templateroller.com/pdf_docs_html/2148/21488/2148872/form-snt-12-supplemental-needs-trust-accounting-new-york-city.png "Form SNT-12 "Supplemental Needs Trust Accounting" - New York City")
![Form DSS-7E "Cityfheps Renewal Request" - New York City (Russian)](https://data.templateroller.com/pdf_docs_html/2105/21051/2105181/form-dss-7e-cityfheps-renewal-request-new-york-city-russian.png "Form DSS-7E "Cityfheps Renewal Request" - New York City (Russian)")
![Form DSS-7E "Cityfheps Renewal Request" - New York City (Korean)](https://data.templateroller.com/pdf_docs_html/2105/21051/2105183/form-dss-7e-cityfheps-renewal-request-new-york-city-korean.png "Form DSS-7E "Cityfheps Renewal Request" - New York City (Korean)")
![Form DSS-7E "Cityfheps Renewal Request" - New York City (Chinese)](https://data.templateroller.com/pdf_docs_html/2105/21051/2105180/form-dss-7e-cityfheps-renewal-request-new-york-city-chinese.png "Form DSS-7E "Cityfheps Renewal Request" - New York City (Chinese)")
![Form DSS-7E "Cityfheps Renewal Request" - New York City (Haitian Creole)](https://data.templateroller.com/pdf_docs_html/2105/21051/2105179/form-dss-7e-cityfheps-renewal-request-new-york-city-haitian-creole.png "Form DSS-7E "Cityfheps Renewal Request" - New York City (Haitian Creole)")
![Form DSS-7E "Cityfheps Renewal Request" - New York City (Arabic)](https://data.templateroller.com/pdf_docs_html/2105/21051/2105178/form-dss-7e-cityfheps-renewal-request-new-york-city-arabic.png "Form DSS-7E "Cityfheps Renewal Request" - New York City (Arabic)")
![Form DSS-7E "Cityfheps Renewal Request" - New York City (Bengali)](https://data.templateroller.com/pdf_docs_html/2105/21051/2105182/form-dss-7e-cityfheps-renewal-request-new-york-city-bengali.png "Form DSS-7E "Cityfheps Renewal Request" - New York City (Bengali)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Russian)](https://data.templateroller.com/pdf_docs_html/2100/21007/2100718/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-russian.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Russian)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Polish)](https://data.templateroller.com/pdf_docs_html/2100/21007/2100717/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-polish.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Polish)")