You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1494A-XLP | Authorized Representative Removal - Extra Large Print (English) | 05/01/2023 |
FAA-1725A-S | Verification of Other Income (Spanish) | 05/01/2023 |
CSE-1061A | Establishing Paternity (English) | 05/01/2023 |
FAA-1546A | Sponsor Deeming Information (English) | 05/01/2023 |
FAA-0574A-S | Withdrawal or Stop Benefits/Appeal Request (Spanish) | 05/01/2023 |
CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (English) | 05/01/2023 |
FAA-0065A-S | Verification of Living Arrangements/Residential Address (Spanish) | 05/01/2023 |
FAA-1765A-S | Autoridad para Divulgar Información | 05/01/2023 |
FAA-1768A | Overpayment Compromise Request Form (English) | 05/01/2023 |
CSE-1061A-S | Establishing Paternity (Spanish) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
UB-099-Y | Certification of Understanding (English / Spanish) | 07/01/2019 |
LCR-1007A | Home Visit Report Supplement to Notice of Inspection and Due Process Rights (English) | 07/01/2019 |
GCI-1049A | No Contact Letter | 07/01/2019 |
LCR-1007A-S | Home Visit Report Supplement to Notice of Inspection and Due Process Rights (Spanish) | 07/01/2019 |
CCA-0206A-S | Cuestionario para la Entrevista de Certificación Inicial | 07/01/2019 |
CCA-1260A-S | Solicitud de Proveedor Suplente | 07/01/2019 |
CCA-1261A-S | Solicitud de Proveedor Certificado de Cuidado de Niños Familiar | 07/01/2019 |
CCA-1260A | Back Up Provider Application | 07/01/2019 |
RSA-1367A | Appeal Rights | 06/01/2019 |
RSA-1367A-LP | Appeal Rights (Large Print) | 06/01/2019 |
Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification