FAMILY INDEPENDENCE ADMINISTRATION Seth W. Diamond, Executive Deputy Commissioner

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FAMILY INDEPENDENCE ADMINISTRATION Seth W. Diamond, Executive Deputy Commissioner ` James K. Whelan, Deputy Commissioner Policy, Procedures and Training Lisa C. Fitzpatrick, Assistant Deputy Commissioner Office of Procedures POLICY BULLETIN #07-91-OPE REVISION TO FOOD STAMP INCOME GUIDELINES FORM W-138Q Date: July 26, 2007 This procedure can now be accessed on the FIAweb. Subtopic(s): Forms The purpose of this policy bulletin is to inform staff at Job Centers and Non-Public Assistance (NPA) Food Stamp (FS) Offices that the Food Stamp Income Guidelines form (W-138Q) has been revised: The Boro Hall Food Stamp Office (F-23) now has extended hours and will be open until 7 PM on Tuesdays. The asterisks denoting Medical Insurance and Community Services Administration (MICSA) Food Stamp Centers have been removed, along with the corresponding footnote, since MICSA Food Stamp Centers were merged with the Family Independence Administration (FIA) effective July 13, 2007. Samples of the form are attached. Center Directors and Office Site Managers must ensure that all previous versions of the W-138Q, including multilingual equivalents, are removed from circulation and recycled. Effective Immediately Related Items: PB #07-24-OPE Please use Print on Demand to obtain Copies of forms. Attachments: W-138Q W-138Q (S) Food Stamp Income Guidelines () Food Stamp Income Guidelines (Spanish) () HAVE QUESTIONS ABOUT THIS PROCEDURE? Call 718-557-1313 then press 2 at the prompt followed by 765 or send an e-mail to FIA Call Center Distribution: X

Form W-138Q (page 1) LLF T h e C I T Y o f N E W Y O R K H u m a n R e s o u r c e s A d m i n i s t r a t i o n F a m i l y I n d e p e n d e n c e A d m i n i s t r a t i o n Food Stamp Income Guidelines Food stamps provide your family with assistance when buying food. They are used in place of cash to buy food at grocery stores or supermarkets. You don t have to be out of work to apply for food stamps. You can be employed and still be eligible for food stamps. You can own your own home and car and still be eligible for food stamps. If you are eligible, you will receive Food Stamp assistance within 30 days. Certain households with little income or savings, or with high shelter costs, can receive Food Stamp benefits within five days. Family Size 1 2 3 4 5 6 7 8 Each additional member Maximum Gross Monthly Income $1,062 $1,430 $1,799 $2,167 $2,535 $2,904 $3,272 $3,640 +369 These income limits were effective October 1, 2006. The Maximum Gross Monthly Income limits do not apply to Food Stamp households with an elderly or disabled individual. To make an application appointment with the Food Stamp Office nearest you, you may appear in person any time between the hours of 9 AM and 5 PM, Monday through Friday. If you wish to make a telephone appointment, call InfoLine at (877) 472-8411 for the telephone number of the nearest Food Stamp Office. Manhattan Brooklyn East End F02 2322 Third Avenue, New York, NY 10035 F15 (SSI only) New York City Food Stamp Offices Union Square F11 109 East 16th Street, 6th floor New York, NY 10003 Ft. Greene F20 275 Bergen Street, Brooklyn, NY 11217 Washington Heights F13 4660 Broadway, New York, NY 10040 Williamsburg F21 30 Thornton Street, Brooklyn, NY 11206 St. Nicholas F14 132 West 125th Street, New York, NY 10027 Coney Island F22 Extended Hours Centers** Waverly F19 12 West 14th Street, New York, NY 10011 Tuesdays) Boro Hall F23 45 Hoyt Street, 6th floor Tuesdays) Greenwood F24 227 Schermerhorn Street, Midwood F25 3050 West 21st Street, North Brooklyn F26 500 Dekalb Avenue, 5th floor Brooklyn, NY 11205 New Utrecht F27 6740 4th Avenue, Brooklyn, NY 11220 Bronx Brighton F28 Stadium F31* 8th floor F61* (Residential Facilities Only) Colgate F32 1209 Colgate Avenue, Bronx, NY 10472 F63* (Homebound Non-SSI only) Rider F38 305 Rider Avenue, Melrose F40 4th floor Fordham F44 2551 Bainbridge Avenue, Bronx, NY 10458 Wednesdays) Queens Staten Island Crotona F46 1910 Monterey Avenue, 5th floor Bronx, NY 10457 Far Rockaway F42/F79 219 Beach 59th Street, Rockaway, NY 11692 St. George F51 Long Island City F43 45-12 32nd Place, Queens F53 32-20 Northern Boulevard, 4th floor Jamaica F54 165-08 88th Avenue, Jamaica, NY 11432 Thursdays) Richmond F99 Fridays) *F61 provides services by mail, phone and fax to residents in State-certified residential treatment group homes. F63 provides food stamps to eligible individuals who are medically verified to be permanently homebound; these services are provided by phone, mail and fax. F31 does not accept new applicants. **Extended Hours Centers 8:30 AM to 7:00 PM, Tuesday through Friday, and 9:00 AM to 5:00 PM on Saturdays.

Form W-138Q (page 2) LLF Human Resources Administration Family Independence Administration Food Stamp Resource Limits/Exemptions The Food Stamp resource limits (including bank accounts, savings bonds and cash on hand) are as follows: $3,000 for a household where at least one person is elderly (60 years or older) or disabled $2,000 for all other households Please note: Other resource items and/or exceptions may apply. We will notify you of any other items and exemptions when you apply for benefits.

Form W-138Q (S) (page 1) LLF T h e C I T Y o f N E W Y O R K H u m a n R e s o u r c e s A d m i n i s t r a t i o n F a m i l y I n d e p e n d e n c e A d m i n i s t r a t i o n Guía de Ingresos de Cupones para Alimentos Los cupones para alimentos le proveen a su familia asistencia a la hora de comprar alimentos. Estos cupones para alimentos se utilizan en lugar de dinero en efectivo para comprar en bodegas o supermercados. Usted no tiene que estar desempleado para solicitar cupones para alimentos. Usted puede estar empleado y aun ser elegible para cupones para alimentos. Usted puede ser elegible para recibir cupones para alimentos aun si es propietario(a) de su casa y automóvil. Si usted es elegible, recibirá asistencia de Cupones para Alimentos dentro de 30 días. Ciertos hogares con poco ingreso o ahorros, o con altos costos de alquiler, pueden recibir beneficios de Cupones para Alimentos dentro de cinco días. Miembros en la Familia 1 2 3 4 5 6 7 8 Cada Miembro Adicional Máximo Ingreso Bruto Mensual $1,062 $1,430 $1,799 $2,167 $2,535 $2,904 $3,272 $3,640 +369 Estos límites de ingresos entraron en vigencia el 1 de octubre, 2006. Los límites del Máximo Ingreso Bruto Mensual no corresponden a hogares de Cupones para Alimentos con personas ancianas o incapacitadas. Para programar una cita de solicitud con la Oficina de Cupones para Alimentos más cercana a usted, puede presentarse a cualquier hora de 9 AM a 5 PM, de lunes a viernes. Si desea programar una cita telefónica, llame a la Línea Directa (InfoLine) al (877) 472-8411 para obtener el número de teléfono de la Oficina de Cupones para Alimentos más cercana a usted. Oficinas de Cupones para Alimentos en la Ciudad de Nueva York Manhattan Brooklyn Bronx Queens Staten Island East End F02 2322 Third Avenue, New York, NY 10035 F15 (SSI only) 253 Schermerhorn Greenwood F24 227 Schermerhorn Brighton F28 Stadium F31* 8vo piso Crotona F46 1910 Monterey Avenue, 5to piso Bronx, NY 10457 Far Rockaway F42/F79* 219 Beach 59th Rockaway, NY 11692 St. George F51 Union Square F11 109 East 16th Street, 6to piso New York, NY 10003 Ft. Greene F20 275 Bergen Street, Brooklyn, NY 11217 Midwood F25 3050 West 21st Street, F61* (Residential Facilities Only) Colgate F32 1209 Colgate Avenue, Bronx, NY 10472 Long Island City F43 45-12 32nd Place, Washington Heights F13 4660 Broadway, New York, NY 10040 Williamsburg F21 30 Thornton Street, Brooklyn, NY 11206 North Brooklyn F26 500 Dekalb Avenue, 5to piso Brooklyn, NY 11205 F63* (Homebound Non-SSI only) Rider F38 305 Rider Avenue, Queens F53 32-20 Northern Boulevard, 4to piso St. Nicholas F14 132 West 125th Street, New York, NY 10027 Coney Island F22 New Utrecht F27 6740 4th Avenue, Brooklyn, NY 11220 Melrose F40 4to piso Centros con Horario Extendido** Waverly F19 12 West 14th Street, New York, NY 10011 (Abierto hasta las 7PM los martes) Boro Hall F23 45 Hoyt Street, 6to piso (Abierto hasta las 7PM los martes) Fordham F44 2551 Bainbridge Avenue, Bronx, NY 10458 (Abierto hasta las 7PM los miércoles) Jamaica F54 165-08 88th Avenue, Jamaica, NY 11432 (Abierto hasta las 7PM los jueves) Richmond F99 (Abierto hasta las 7PM los viernes) *El F61 proporciona servicios por correo, por teléfono y por fax a residentes de hogares de tratamiento en grupo autorizados por el Estado. El F63 proporciona cupones para alimentos a personas elegibles que estén médicamente verificadas como permanentemente confinadas al hogar. Estos servicios son proporcionados por teléfono, por correo y por fax. El F31 no acepta nuevos solicitantes. **Centros con Horario Extendido 8:30 AM a 7:00 PM de martes a viernes, y de 9:00 AM a 5:00 PM los sábados.

Form W-138Q (S) (page 2) LLF Human Resources Administration Family Independence Administration Límites/Exenciones de Recursos respecto a Cupones para Alimentos Los límites de recursos respecto a Cupones para Alimentos (incluidos cuentas bancarias, bonos de ahorro y dinero en efectivo) son los siguientes: $3,000 para los hogares con por lo menos una persona anciana (60 años o más de edad) o incapacitada $2,000 para todos los demás hogares Favor de notar: Puede que otros límites o exenciones de recursos correspondan a su caso. Usted será notificado(a) de cualquier otro límite o exención de recursos cuando solicite los beneficios.