Attention EBT Cardholders

A small number of Electronic Benefits Transfer (EBT) cardholders may be experiencing issues using their EBT cards. OTDA is aware of the issue and is continuing to work closely with our EBT vendor to resolve it as quickly as possible. Those affected should contact their local department of social services about getting a temporary replacement card.

Last updated: May 23, 2024, 3:15 PM

Forms

OTDA Home Programs Forms

Overview

If you are blind or visually impaired many of OTDA's forms are available in alternative format.

This page contains links to PDF documents. Download Acrobat Reader to view these documents.

If you use assistive technologies to read PDFs, the preferred method is to download the PDF and view it directly with your preferred assistive software.

Application for Certain Benefits and Services

Common application for Public Assistance, Child Care in Lieu of Public Assistance, the Supplemental Nutrition Assistance Program (SNAP), Medicaid and SNAP, Medicaid and Public Assistance, Services included Foster Care, Child Care Assistance, and Emergency Assistance only.

Recertification Form for Certain Benefits and Services

Recertification form for Public Assistance, Supplemental Nutrition Assistance Program (SNAP), Medicaid and SNAP, and Medicaid and Public Assistance.

Supplemental Nutrition Assistance Program (SNAP) Benefits

SCAM Alert

Scammers offer phony SNAP application assistance

Home Energy Assistance Program (HEAP)

The HEAP application is available when HEAP is open.

State Supplement Program (SSP)

Child Support Services

Temporary Assistance for Needy Families (TANF)

Application Booklets

Information on your rights and responsibilities, and the services and programs available to you.

What are my Rights?

This page contains links to PDF documents. Download Acrobat Reader to view these documents.

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