You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
FAA-0255A-S | Afirmación De Hogares Por Separado | 05/01/2023 |
FAA-0574A-S | Retirar o Suspender Beneficios/Solicitud de Apelación | 05/01/2023 |
FAA-1725A-S | Verificación de Otros Ingresos | 05/01/2023 |
DDD-1345A | Medical Justification for Home Modifications (English) | 05/01/2023 |
CCA-1170A | Withdrawal or Termination Request for Child Care Providers | 05/01/2023 |
FAA-0255A | Separate Household Status Statement | 05/01/2023 |
FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
RSA-1390A | Statement of Services Rendered | 07/01/2020 |
GCI-1085A-S | Lista de verificación para el examen de la visión | 07/01/2020 |
GCI-1042A | Family Survey | 07/01/2020 |
GCI-1042A-S | Encuesta Familiar | 07/01/2020 |
CCA-0229A-FY21 | Child Care Assistance Gross Monthly Income Eligibility Chart And Fee Schedule FY 2021 (English/Spanish) | 07/01/2020 |
CSE-1185A | Affidavit of Credible Person Identifying Affiant (English/Spanish) | 07/01/2020 |
CSE-1016A | Waiver of Paternity Affidavit (English/Spanish) | 06/01/2020 |
GCI-1082A | Consent for Screening - Prior Written Notice | 06/01/2020 |
CSE-1314A | Child Supplemental Page (English / Spanish) | 06/01/2020 |
LCR-1053A | Renewal Application Worksheet (English) | 06/01/2020 |
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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