Doh 2794-2026

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  1. Click ‘Get Form’ to open the doh 2794 application in the editor.
  2. Begin by filling out Section A, 'Applicant Information.' Enter your full name, social security number, and date of birth. Ensure you provide a valid address as proof of New York State residency.
  3. In Section B, 'Living Arrangement,' list all household members. Indicate their relationship to you and whether they live with you.
  4. Proceed to Section C, 'Income.' Check all applicable income sources for yourself and household members. Provide gross amounts and frequency of income received.
  5. In Section D, 'Liquid Assets,' check all applicable asset sources and indicate their current balance or value. Remember to include proof of these assets.
  6. Complete Section E regarding any health coverage you may have. Attach copies of your health insurance cards if applicable.
  7. Finally, in Section F, provide alternate contact information if necessary and sign the certification statement at the bottom before submitting your application.

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