DOCUMENTS REQUIRED FOR YOUR …

1A Lowndes Avenue Huntington Station, 11746 (631) 427-6220 - Fax (631) 427-6288 DOCUMENTS REQUIRED FOR your recertification packet If any member of your household receives any of the following types of income listed below, please provide the following: Mailing name, address and telephone number of the source of income and documentation about current amounts received. (For example, Award Letters, copies of paystubs). I. INFORMATION ABOUT your HOUSEHOLD INCOME AND ASSETS: A) EMPLOYMENT INCOME FOR EVERY MEMBER OF your HOUSEHOLD THAT IS WORKING, PLEASE PROVIDE THE FOLLOWING: 1. Paystubs Current & consecutive (Four if paid weekly or two if paid bi-weekly/semi-monthly). 2. Latest W-2 Forms 3. Copy of your most recent Tax Return 4. Other types of expected income such as tips, overtime, commissions, profit sharing programs, etc.

1A Lowndes Avenue Huntington Station, N.Y. 11746 (631) 427-6220 - Fax (631) 427-6288 DOCUMENTS REQUIRED FOR YOUR RECERTIFICATION PACKET If any member of your household receives any of the following types of income listed below,

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