You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-1479A-S | Notice of Extension (Spanish) | 06/01/2023 |
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FAA-1823A | Keep Your Nutrition and Cash Assistance Benefits Safe (English/Spanish) | 06/01/2023 |
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FAA-0155B-S | Determinación de Principal Devengador(a) de Ingresos (PWE por sus siglas en inglés) | 06/01/2023 |
|
DDD-1713A | DDD Customer Service Center (English) | 06/01/2023 |
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FAA-1439A-SXLP | Self-Employment Income Statement - Extra Large Print (Spanish) | 06/01/2023 |
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FAA-0059A | Authority to Release Records | 06/01/2023 |
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FAA-1821A-S | Elderly Simplified Application Project (ESAP) Nutrition Assistance Application (Spanish) | 06/01/2023 |
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FAA-0260A | Claim of Sexual Assault or Incest | 06/01/2023 |
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DDD-1713A-S | DDD Customer Service Center (Spanish) | 06/01/2023 |
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FAA-1439A-XLP | Self-Employment Income Statement - Extra Large Print (English) | 06/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
LCR-1005A | Notice of Inspection Rights | 10/01/2022 |
|
DDD-1991A | DDD Eligibility Checklist (English) | 10/01/2022 |
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DDD-1991A-S | DDD Eligibility Checklist (Spanish) | 10/01/2022 |
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CCA-1021A | Unpaid Co-payment Worksheet | 10/01/2022 |
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GCI-1147A | Records Request Response (AzEIP) | 10/01/2022 |
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CCA-1021A-S | Informe de Copagos Atrasados | 10/01/2022 |
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LCR-1005A-S | Aviso de los Derechos Durante Inspección | 10/01/2022 |
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DDD-1747A-S | Contrato De Residencia Para Las Residencias De Vivienda Asistida (ALF) | 10/01/2022 |
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RSA-1312A-LP | Authorization for Disclosure of Health Information to RSA (Large Print) | 09/01/2022 |
|
LCR-1025A | Application for Initial HCBS Certification (English) | 09/01/2022 |
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