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-0221A-S | Declaración de Servicios del Proveedor de Cuidado en Casa de Familia | 05/01/2023 |
|
FAA-1004A-S | Designation of EBT Alternate Card Holder (Spanish) | 05/01/2023 |
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FAA-0257A | Individual Development Account Agreement | 05/01/2023 |
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FAA-1004A-SLP | Designation of EBT Alternate Card Holder - Large Print (Spanish) | 05/01/2023 |
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FAA-0259A | Unwed Minor Parent Abuse/Neglect Claim | 05/01/2023 |
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FAA-1004A-SXLP | Designation of EBT Alternate Card Holder - Extra Large Print (Spanish) | 05/01/2023 |
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FAA-1366A | Eligibility Requirements | 05/01/2023 |
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FAA-0259A-S | Denuncia de Abuso o Negligencia de un Padre Soltero que es Menor de Edad | 05/01/2023 |
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AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
|
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
|
DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
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CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
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AAA-1344A | Direct Service Position | 08/01/2021 |
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LCR-1085A | Adult Protective Services Records Check Request | 08/01/2021 |
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AAA-1369A | Quarterly Report Packet | 08/01/2021 |
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AAA-1344A-S | Posición de Servicio Directo | 08/01/2021 |
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FAA-1810A | Register to vote (Bilingual) | 08/01/2021 |
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DERS-1057A | Direct Service Position | 08/01/2021 |
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CCA-1212A | Direct Service Position (Certification Form) | 07/01/2021 |
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