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 |
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FAA-0412A-S | Change Report (Spanish) | 05/01/2023 |
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FAA-1701A-LP | Verification of Terminated Employment - Large Print (English) | 05/01/2023 |
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FAA-0053A-XLP | Verification of New/Current Employment - Extra Large Print (English) | 05/01/2023 |
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FAA-0060A | Authority to Release Student Information | 05/01/2023 |
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CSE-1061A-S | Establecer la Paternidad | 05/01/2023 |
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FAA-1725A-S | Verificación de Otros Ingresos | 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-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
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FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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DDD-2101A | Electronic Visit Verification (EVV) Paper Timesheet Attestation (English) | 09/01/2021 |
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DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
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CSE-1281A | Agreement to Accept Service by Mail Paternity or Establishment (English/Spanish) | 09/01/2021 |
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DDD-2099A-S | Plan de contingencia/respaldo del miembro para la verificación de visita electrónica (EVV) | 09/01/2021 |
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DDD-2100A-S | Hoja de horas de verificación de visita electrónica de DDD | 09/01/2021 |
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DDD-2100A | DDD Electronic Visit Verification Paper Timesheet | 09/01/2021 |
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CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
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DDD-2101A-S | Electronic Visit Verification (EVV) Paper Timesheet Attestation (Spanish) | 09/01/2021 |
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CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
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LCR-1085A | Adult Protective Services Records Check Request | 08/01/2021 |
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