You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
|
CCA-1170A | Withdrawal or Termination Request for Child Care Providers | 05/01/2023 |
|
FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
|
FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
|
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
|
FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
|
FAA-1533A | Verification of Unfitness for Work for Adults | 05/01/2023 |
|
FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
|
DDD-1345A | Medical Justification for Home Modifications (English) | 05/01/2023 |
|
CCA-1170AS | Petición para el Retiro o Terminación de Solicitud - Para Proveedores de Cuidado de Niños | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-0024A | Employment and Wage Verification Statement (English) | 11/01/2021 |
|
CCA-0041A | Fair Hearing Request | 11/01/2021 |
|
CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
|
CCA-0044A | Verification of Shelter Case Plan (English) | 11/01/2021 |
|
CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
|
SNA-1066A | Voluntary Participation Agreement | 10/01/2021 |
|
DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
|
DDD-2102A | Electronic Visit Verification (EVV) Designee Attestation (English) | 09/01/2021 |
|
CSE-1168A | Agreement to Accept Service by Mail - TANF Workshops | 09/01/2021 |
|
DDD-2102A-S | Electronic Visit Verification (EVV) Designee Attestation (Spanish) | 09/01/2021 |
Stay up-to-date with news and updates delivered straight to your inbox
Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification