Ldss 5145-2025

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  1. Click ‘Get Form’ to open the ldss 5145 in the editor.
  2. Begin with Part A – Referral. Fill in your personal information, including your name, contact details, and relationship to the child. Ensure you check the box if you are applying for Temporary Assistance.
  3. Proceed to Part B – Child Information. For each child involved, provide their name, date of birth, and any relevant health care coverage details. If there are two children, complete this section for both.
  4. In Part C – Supporting Documentation, review the list of required documents. Attach copies of necessary paperwork such as identification and proof of income directly through our platform.
  5. Once all sections are completed, review your entries for accuracy before submitting your referral electronically.

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Your Local Department of Social Services (LDSS) may be able to assist you in obtaining your health insurance coverage and/or provide you with information about other programs and benefits you may qualify.
Healthfirst offers health plans for all ages, needs, and incomes, including: Medicare Advantage Plans. Managed Long-Term Care Plans. Medicaid Managed Care.
Login to your NY.Gov account. If you do not have a NY.Gov ID, you need to create a NY.gov ID. If you have only one account, the balance / payment information will be displayed. If you have more than one account, select which account youd like to view.

People also ask

To check payment status, you can view your account online or call the Child Support Information Line at 800-846-0773, a toll-free, 24-hour-a-day, seven-days-a-week service.

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