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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FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
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FAA-1765A-S | Autoridad para Divulgar Información | 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-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
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FAA-1494A-LP | Authorized Representative Removal (Large Print) | 05/01/2023 |
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FAA-0620A | Treatment Center Change Report | 05/01/2023 |
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DDD-2131B | Volunteers Needed/ Necesitan Voluntarios | 05/01/2023 |
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FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
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FAA-1004A-XLP | Designation of EBT Alternate Card Holder - Extra Large Print (English) | 05/01/2023 |
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FAA-0574A | Withdrawal or Stop Benefits/Appeal Request | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-1212A-S | Puesto de Servicio Directo (Formulario de certificación) | 07/01/2021 |
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DDD-2104A | Member Interdisciplinary Team Summary | 07/01/2021 |
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DDD-2106A | Member's Circles of Support | 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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UIB-0098C | Eligibility Investigation Record - WC ALT. Base Period | 06/01/2021 |
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DDD-2106A-S | Círculos de Apoyo del Miembro | 06/01/2021 |
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UIB-0126A | Request for Reconsideration/Appeal (English) | 06/01/2021 |
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UIB-0098K | Eligibility Investigation Record - Transient Lodging Seasonal Employment | 06/01/2021 |
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UIB-0126A-S | Request for Reconsideration/Appeal (Spanish) | 06/01/2021 |
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UIB-0098M | Record of Employment | 06/01/2021 |
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