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

Appendix C – Page 18 Rev. 3/2022

LDSS-4230A SNAP CONCILIATION NOTIFICATION For copies of the LDSS-4230 use the following links: English version LDSS-4230A SNAP Conciliation Notification Spanish version LDSS-4230A(S) SNAP Conciliation Notification Instructions for Completing the LDSS-4230A The LDSS-4230A should be used for SNAP-only work registrants who fail to comply with a SNAP E&T requirement in those instances where a manual notice is needed. The upper section of the document is used to provide identifying information which is self- explanatory. Each box must be filled in. The worker must specify the instance(s) of refusal or failure to comply and detail the work activity or work requirement the individual failed to comply with. Workers should refrain from using acronyms or abbreviated descriptions for work activity assignments. The contact section must be filled out and indicate the worker name, agency contact phone number, and the date that contact must occur by. The date should allow individuals at least 10 days from the date of the conciliation notice the opportunity to respond to the conciliation notice and/or re-engagement in SNAP work activities. Workers should select one of the available options for demonstrating compliance to avoid a SNAP sanction to instruct the client to contact the agency for information, to directly report to a provider or to comply with job search to demonstrate compliance. Note: the date on the notice should allow individuals at least ten days from the date of the conciliation notice (regardless of case type) for the opportunity to respond to the conciliation notice and/or re-engagement in SNAP work activities The LDSS-4230A or approved local equivalent must be issued to the client before a ten-day notice of adverse action may be sent.