You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-1345A | Medical Justification for Home Modifications (English) | 05/01/2023 |
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CCA-1175A | Landlord Permission to Provide Family Child Care Service | 05/01/2023 |
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FAA-1546A | Sponsor Deeming Information | 05/01/2023 |
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FAA-0053A | Verification of New/Current Employment (English) | 05/01/2023 |
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FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
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FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
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FAA-0559A | Food Distribution / Nutrition Assistance Program Participation | 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-1546A-S | Información de Determinar a un Patrocinador | 05/01/2023 |
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CSE-1061A | Establishing Paternity | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-1984A-S | Behavior Plan / Packet Requirements (Spanish) | 11/01/2021 |
|
SNA-1066A | Voluntary Participation Agreement | 10/01/2021 |
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DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
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DDD-2100A | DDD Electronic Visit Verification Paper Timesheet | 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-2101A-S | Electronic Visit Verification (EVV) Paper Timesheet Attestation (Spanish) | 09/01/2021 |
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CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
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DDD-2102A | Electronic Visit Verification (EVV) Designee Attestation (English) | 09/01/2021 |
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CSE-1168A | Agreement to Accept Service by Mail - TANF Workshops | 09/01/2021 |
|
CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
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