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Documents Center
Reports, Forms, Pamphlets and Policies
You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Find a Document
- Click on the tab that corresponds with the type of document type you are looking for, or click on the "All Documents" tab to search through all available documents. You can refine your search by selecting a category from the Filter by Category drop-down.
- Type in a number or keyword in the "Search by Name, Number, or Keyword" box and click the Search button. When searching for a document by the exact title (form name), place the title within quotation marks.
- You can click on the column headers to sort the search results.
| Number | Document Name | Effective Date |
|---|---|---|
| FAA-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
| GCI-1041A | Consent to Bill Health Insurance | 05/01/2023 |
| CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (English) | 05/01/2023 |
| FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance (English) | 05/01/2023 |
| FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 05/01/2023 |
| FAA-1494A-XLP | Authorized Representative Removal - Extra Large Print (English) | 05/01/2023 |
| FAA-1725A-S | Verification of Other Income (Spanish) | 05/01/2023 |
| FAA-1565A | Nutrition Assistance Drug Testing Agreement (English) | 05/01/2023 |
| CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
| FAA-1494A | Authorized Representative Removal (English) | 05/01/2023 |
| Number | Document Name | Effective Date |
|---|---|---|
| LCR-1007A-S | Home Visit Report Supplement to Notice of Inspection and Due Process Rights (Spanish) | 07/01/2019 |
| CCA-0206A-S | Cuestionario para la Entrevista de Certificación Inicial | 07/01/2019 |
| CCA-1260A-S | Solicitud de Proveedor Suplente | 07/01/2019 |
| CCA-1261A-S | Solicitud de Proveedor Certificado de Cuidado de Niños Familiar | 07/01/2019 |
| CCA-1260A | Back Up Provider Application | 07/01/2019 |
| CCA-1261A | Certified Family Child Care Provider Application | 07/01/2019 |
| UB-099-Y | Certification of Understanding (English / Spanish) | 07/01/2019 |
| LCR-1007A | Home Visit Report Supplement to Notice of Inspection and Due Process Rights (English) | 07/01/2019 |
| RSA-1367A | Appeal Rights | 06/01/2019 |
| RSA-1367A-LP | Appeal Rights (Large Print) | 06/01/2019 |
Arizona State Resources
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
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