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-1249A-LP | Verification of Disability (Large Print) | 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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DDD-2203A | Daily Shift Log (English) | 05/01/2023 |
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FAA-1004A-S | Designation of EBT Alternate Card Holder (Spanish) | 05/01/2023 |
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FAA-0574A-S | Retirar o Suspender Beneficios/Solicitud de Apelación | 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-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
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DDD-1345A | Medical Justification for Home Modifications (English) | 05/01/2023 |
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CCA-1170AS | Petición para el Retiro o Terminación de Solicitud - Para Proveedores de Cuidado de Niños | 05/01/2023 |
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FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
GCI-1098A | AzEIP Public Awareness Materials Order Form | 11/01/2021 |
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DDD-1984A-S | Behavior Plan / Packet Requirements (Spanish) | 11/01/2021 |
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CCA-0041A | Fair Hearing Request | 11/01/2021 |
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CCA-1186A | Authority to Release Information | 11/01/2021 |
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CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
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CCA-0044A | Verification of Shelter Case Plan (English) | 11/01/2021 |
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CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
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SNA-1066A | Voluntary Participation Agreement | 10/01/2021 |
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DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
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DDD-2102A | Electronic Visit Verification (EVV) Designee Attestation (English) | 09/01/2021 |
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