You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
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FAA-1004A-XLP | Designation of EBT Alternate Card Holder - Extra Large Print (English) | 05/01/2023 |
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FAA-0412A | Change Report (English) | 05/01/2023 |
|
CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
|
FAA-0098C-S | Solicitud de Audiencia por Ajuste de Transacción EBT | 05/01/2023 |
|
FAA-0255A-S | Afirmación De Hogares Por Separado | 05/01/2023 |
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FAA-1004A-SLP | Designation of EBT Alternate Card Holder - Large Print (Spanish) | 05/01/2023 |
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FAA-1725A-S | Verificación de Otros Ingresos | 05/01/2023 |
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DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
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CCA-1170A | Withdrawal or Termination Request for Child Care Providers | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-1235A | CCA Change Report | 11/01/2021 |
|
CCA-1235A-S | CCA Informe de Cambios | 11/01/2021 |
|
CCA-0041A | Fair Hearing Request | 11/01/2021 |
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CCA-1186A | Authority to Release Information | 11/01/2021 |
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CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
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CCA-0044A | Verification of Shelter Case Plan (English) | 11/01/2021 |
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CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
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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 |
|
CSE-1281A | Agreement to Accept Service by Mail Paternity or Establishment (English/Spanish) | 09/01/2021 |
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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