Advocate Inquiry Submission Form

Please select type of inquiry*

Advocate Inquiry about CA, CA/SNAP, SNAP-only (select if you have not yet received a decision in a Fair Hearing on the issue you're inquiring about)

SNAP Fair Hearing Decision Compliance (select if you have an inquiry related to compliance with a Fair Hearing Decision on a SNAP-only case)

Note: If you have an inquiry related to compliance with a Fair Hearing Decision on a CA or CA/SNAP case, you can contact CAFHCompl@hra.nyc.gov for assistance.

First Name*

Last Name*

Email Address

Home Phone

Street Address*

City*

Zip*

Case Number

First Name*

Last Name*

Email*

Business Phone

Organization

Street Address

City

Zip

SNAP Centers Select F02 East End (M) F13 Washington Heights (M) F14 St. Nicholas (M) F15 (SSI) Supplemental Security Income Office F19 Waverly (M) F20 Fort Greene (M) F21 Williamsburg (M) F22 Coney Island Change Center F26 North Brooklyn F28 East New York F40 Hunts Point F45 Concourse (M) F46 Crotona F53 Queens (M) F54 Jamaica (M) F61 Residential Treatment Center F79 Rockaway (M) F99 Richmond (M)

Job Centers Select 13 Waverly (M) 17 Family Services Call Center (FSCC) 18 St. Nicholas Job Center 23 East End (M) 35 Dyckman (M) 37 East River (M) 38 Rider 39 Union Square Job Center 40 Melrose 44 Fordham (M) 45 Concourse (M) 46 Crotona 47 Refugee 52 Residential Treatment Service Center 53 Queens (M) 54 Jamaica (M) 62 Michael J. Handy Veterans Job Center 63 Coney Island 64 Dekalb 66 Bushwick (M) 67 Clinton Hill (M) 70 Bayridge 71 Intensive Services Center 79 Rockaway (M) 80 Seaport 84 SeniorWorks 99 Richmond (M)

Fair Hearing Number (if any)

Date Fair Hearing Scheduled

Is there a Rivera Request for the above Fair Hearing number?

Yes

No

Is this inquiry related to decision compliance (DAFH)?

Yes

No

Reason for Inquiry*