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NYS Office of Temporary and Disability Assistance- TA and SNAP Employment Policy Manual

Appendix C – Page 12 Rev. 3/2022

LDSS-5193 IMPORTANT INFORMATION ABOUT SNAP WORK RULES (GENERAL, MANDATORY E&T, AND ABAWD) For the most recent copy of the LDSS-5193, please use the following link: http://otda.state.nyenet/ldss_eforms/ When to Use an LDSS-5193

In accordance with guidance outlined in 22-ADM-01 Oral and Written Requirements to Inform SNAP Applicants and Recipients of SNAP Work Rules districts are required to provide a notice of consolidated work requirements and oral explanation to all households where at least one member is subject to a SNAP work requirement, describing the pertinent work requirements. LDSS-5193 Important Information about SNAP Work Rules (General, Mandatory E & T and ABAWD) includes information regarding the general SNAP work requirements, mandatory SNAP E&T, and the ABAWD work requirements. This notice should be provided to all SNAP households where at least one household member is subject to the ABAWD work requirements. The LDSS-5193 should be issued as explained above at certification, recertification, and when a previously exempt household member or new household member becomes subject to work requirements. This notice should not be used during periods of a statewide ABAWD waiver as during that time ABAWDs residing in all areas of New York State are not be subject to the ABAWD requirements. Throughout the duration of a statewide ABAWD waiver, districts should use the LDSS-5193A described under the section LDSS-5193A Important Information about SNAP Work Rules (General and Mandatory E&T) below. Additionally, the LDSS-5193 Important Information about SNAP Work Rules (General, Mandatory E & T, and ABAWD), which includes all relevant information about the ABAWD work rules, replaced the LDSS-5072 Informational Letter Regarding Able-Bodied Adults Without Dependents (ABAWD) Requirements. Districts must no longer use the LDSS-5072 which became obsolete with the implementation of the LDSS-5193. Instructions for Completion

Districts are required to complete the information in the top portion of the first page of the notice including: Date, Case Number, and District Contact Number. In the applicable work requirements sections, districts should list all members of the household who are subject to each of the different types of requirements. The three charts on the first page of the notice must be completed in accordance with the household’s specific circumstances: The first chart should include the names of each household member subject to the general SNAP work requirements. The second chart should include the names of each household member who is subject to mandatory SNAP E&T.