This form will ask you for some information about you and your household.

It's not going to complete the entire form for you, but it's intended to simplify filling out the very long "NEW YORK STATE APPLICATION FOR CERTAIN BENEFITS AND SERVICES" and "Application For Child Care Assistance" forms.

For example, it will fill in repetitive information about household members' names.

Benefit Kitchen and Community Lawyer will not store your data. Be sure to download the PDFs at the end of this interview.