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You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
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CCA-1163A-S | Afidávit de Exención de Vacunación - Para Miembros del Hogar de 13 años de edad y Menores | 05/01/2023 |
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FAA-0257A | Individual Development Account Agreement | 05/01/2023 |
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FAA-0098C-S | Solicitud de Audiencia por Ajuste de Transacción EBT | 05/01/2023 |
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FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
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CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
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FAA-0259A | Unwed Minor Parent Abuse/Neglect Claim | 05/01/2023 |
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FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
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FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
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FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
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FAA-1546A | Sponsor Deeming Information | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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CCA-1276A | Action Plan (English) | 06/01/2021 |
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UIB-0098B | Eligibility Investigation Record - Pension | 06/01/2021 |
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WIO-1144A | Eligible Training Provider List (LWDB) | 06/01/2021 |
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WIO-1144B | Eligible Training Provider List LWDB Monitoring Tool | 06/01/2021 |
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UIB-0098L | Eligibility Investigation Record - Transient Lodging Seasonal Employment | 06/01/2021 |
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UIB-0098E | Eligibility Investigation Record - Education/School Bus Wages | 06/01/2021 |
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UIB-0098F | Job Offer Development, Referral, Eligibility Investigation Record | 06/01/2021 |
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DDD-2107A | What Works and What Doesn't Work Worksheet | 06/01/2021 |
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DDD-2107A-S | Hoja de Trabajo Sobre lo que Funciona y lo que no Funciona | 06/01/2021 |
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DDD-2106A | Member's Circles of Support | 06/01/2021 |
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