You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0574A-SLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) | 05/01/2023 |
|
GCI-1041A-S | Consentimiento para el Uso del Seguro de Salud | 05/01/2023 |
|
FAA-0412A-LP | Change Report - Large Print (English) | 05/01/2023 |
|
FAA-0412A | Change Report (English) | 05/01/2023 |
|
FAA-0098C-S | Solicitud de Audiencia por Ajuste de Transacción EBT | 05/01/2023 |
|
FAA-0255A-S | Afirmación De Hogares Por Separado | 05/01/2023 |
|
CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger | 05/01/2023 |
|
FAA-1725A-S | Verificación de Otros Ingresos | 05/01/2023 |
|
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
|
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2102A-S | Electronic Visit Verification (EVV) Designee Attestation (Spanish) | 09/01/2021 |
|
CSE-1168A | Agreement to Accept Service by Mail - TANF Workshops | 09/01/2021 |
|
CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
|
DDD-2098A | Hourly Nursing Assessment Tool (H-NAT) | 09/01/2021 |
|
CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
|
DDD-2101A | Electronic Visit Verification (EVV) Paper Timesheet Attestation (English) | 09/01/2021 |
|
CSE-1281A | Agreement to Accept Service by Mail Paternity or Establishment (English/Spanish) | 09/01/2021 |
|
DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
|
DDD-2099A-S | Plan de contingencia/respaldo del miembro para la verificación de visita electrónica (EVV) | 09/01/2021 |
|
LCR-1079A | Developmental Home Compliance Review | 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