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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-1506A | Statement of No Income (English) | 05/01/2023 |
| FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
| GCI-1041A-S | Consentimiento para el Uso del Seguro de Salud | 05/01/2023 |
| FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
| FAA-1725A | Verification of Other Income | 05/01/2023 |
| FAA-0574A-SLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) | 05/01/2023 |
| CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (English) | 05/01/2023 |
| GCI-1041A | Consent to Bill Health Insurance | 05/01/2023 |
| CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
| DDD-1678A | Home Modifications Service Assessment (English) | 05/01/2023 |
| Number | Document Name | Effective Date |
|---|---|---|
| CCA-0218B | Sign-In/Sign-Out Record (Extended Version) | 10/01/2019 |
| CCA-0218B-S | Registro de Entradas y Salidas (Versión extendida) | 10/01/2019 |
| DDD-1532A | Hardship Reduction Request (English) | 09/01/2019 |
| DDD-1532A-S | Hardship Reduction Request (Spanish) | 09/01/2019 |
| DDD-0403A | Reference Request (English) | 09/01/2019 |
| RSA-1383A | BEP Training - Applicant Checklist | 09/01/2019 |
| CSE-1007 | Customer Satisfaction Survey | 09/01/2019 |
| RSA-1386A | BEP 8 Step Process | 09/01/2019 |
| RSA-1384A | BEP Job-Shadowing Evaluation | 09/01/2019 |
| CSE-1007A-S | Encuesta de Satisfacción del Cliente | 09/01/2019 |
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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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