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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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-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
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FAA-0574A-SLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) | 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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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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AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
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FAA-1494A-SXLP | Remoción de un(a) Representante Autorizado(a) (Letra Extra Grande) | 05/01/2023 |
|
FAA-1799A | Drug/Alcohol Treatment Center Training Acknowledgment | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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CCA-1211B | Attachment to Request for Search of Background Checks (CCA-1211A) Disqualifying Acts (English) | 04/01/2021 |
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CCA-1211B-S | Attachment to Request for Search of Background Checks (CCA-1211A-S) Disqualifying Acts (Spanish) | 04/01/2021 |
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CCA-1234A | Family Child Care Home Backup Provider Backup, Discipline, and Transportation Agreement | 04/01/2021 |
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TAA-1065A | Notice of Potential Trade Adjustment Assistance Eligibility | 04/01/2021 |
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CCA-1234A-S | Proveedor Suplente de Cuidado de Niños en el Hogar Acuerdo de Suplente, Disciplina y Transporte | 04/01/2021 |
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AAA-1218A | Arizona Family Caregiver Support Program (FCSP) Quarterly Summary Report | 03/01/2021 |
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DDD-1530A-SLP | Managed Risk Agreement Services and/or Placement -Large Print (Spanish) | 03/01/2021 |
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DDD-2090A | Program Integrity Requirements Verification | 03/01/2021 |
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ESA-1338A | Language Line Translation Services Utilized | 03/01/2021 |
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DDD-2093A | DDD Behavioral Health Advocate Referral | 03/01/2021 |
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