Transcription of DOCUMENTS REQUIRED FOR YOUR RECERTIFICATION PACKET
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Example: dental hygienist
DOCUMENTS REQUIRED FOR YOUR RECERTIFICATION PACKET
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.
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).
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