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Click ‘Get Form’ to open the ldss 3370 2003 form in the editor.
Begin by filling in the agency information at the top of the form. Enter your three-digit agency code, followed by your Resource I.D. and clearance category letter code.
In the applicant/household member area, list all household members, including yourself, your spouse, and children. Ensure you include any maiden names or aliases.
Provide complete address histories for each household member aged 18 or older since January 1973. Use additional pages if necessary.
Sign and date the form where indicated. Remember that signatures must correspond to the names listed and be dated within six months.

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Versions	Form popularity	Fillable & printable
2011	4.9 Satisfied (431 Votes)
2009	4.3 Satisfied (159 Votes)
2007	4 Satisfied (49 Votes)
2003	4.3 Satisfied (169 Votes)

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What is the LDSS 3370 form used for?

The purpose of collecting the demographic data on other persons in your household who are not screened pursuant to Section 424-a of the Social Services Law is to enable the NYS Office of Children and Family Services to identify with the greatest degree of certainty whether the person(s) being screened is the subject of ...

What is a SCR form?

State Central Register Database Check Form Each SCR Database Check form submitted should be reviewed for completeness and legibility by the camp program. If the form is incomplete or illegible, it will be returned to you for corrections.