You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
DDD-2102A | Electronic Visit Verification (EVV) Designee Attestation (English) | 09/01/2021 |
DDD-2102A-S | Electronic Visit Verification (EVV) Designee Attestation (Spanish) | 09/01/2021 |
DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan (English) | 09/01/2021 |
DDD-2099A-S | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan (Spanish) | 09/01/2021 |
DDD-2101A | Electronic Visit Verification (EVV) Paper Timesheet Attestation (English) | 09/01/2021 |
DDD-2101A-S | Electronic Visit Verification (EVV) Paper Timesheet Attestation (Spanish) | 09/01/2021 |
GCI-1218A | Eligibility AzEIP Programmatic Meeting-June 2024 | 08/01/2024 |
UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
UIB-0098D | Eligibility Investigation Record - Administrative Penalty | 09/01/2018 |
Number | Document Name | Effective Date |
---|---|---|
FAA-1533A | Verification of Unfitness for Work for Adults | 05/01/2023 |
FAA-1529A | Verification of Volunteers Hours | 06/01/2023 |
ESA-1193A | Veteran's Assessment Tool (English) | 08/01/2024 |
ESA-1193A-S | Veterans' Assessment Tool (Spanish) | 08/01/2024 |
GCI-1085A | Vision Screening Checklist | 07/01/2020 |
UB-433-FF | Voluntary Election for Federal/State Income Tax Withholding (English/Spanish) | 05/01/2017 |
SNA-1066A | Voluntary Participation Agreement (English) | 10/01/2021 |
DDD-2083A | Voluntary Withdrawal Form - Large Print (English) | 09/01/2024 |
LCR-1041A | Voluntary Withdrawal of Application for Licensure or Voluntary Closure of License | 07/01/2023 |
AAA-1180A | Volunteer Application | 12/01/2022 |
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