You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
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FAA-0412A-XLP | Change Report - Extra Large Print (English) | 05/01/2023 |
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DDD-2203A | Daily Shift Log (English) | 05/01/2023 |
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FAA-1249A | Verification of Disability | 05/01/2023 |
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DDD-1622A | Home Modification Requests Support Coordinator’s (SC) Checklist (English) | 05/01/2023 |
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FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
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FAA-1546A | Sponsor Deeming Information | 05/01/2023 |
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GCI-1041A-S | Consentimiento para el Uso del Seguro de Salud | 05/01/2023 |
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FAA-0412A-LP | Change Report - Large Print (English) | 05/01/2023 |
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FAA-1725A | Verification of Other Income | 05/01/2023 |
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FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2149A | Authorization to Release Records | 08/01/2022 |
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FAA-1570A | Cash Assistance Drug Conviction Sanction Agreement | 08/01/2022 |
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FAA-1828A | Provider Determination | 08/01/2022 |
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HRP-1028A-S | Solicitud para Beneficios (TEFAP, CSFP) | 08/01/2022 |
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HRP-1033A | Commodity Senior Food Program (CSFP) ID/Transfer Card (English/Spanish) | 07/01/2022 |
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UIB-0101C-S | Declaración Jurada del Plan de Búsqueda de Trabajo | 07/01/2022 |
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CCA-0231A-2022 | Child Care Assistance Unwed Minor Parent Deeming Worksheet | 07/01/2022 |
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CS-127-PF | Acknowledgment of Paternity (English / Spanish) | 07/01/2022 |
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HRP-1039A | Commodity Senior Food Program (CSFP) Participant Rights and Obligations | 07/01/2022 |
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HRP-1001A | USDA Commodity Loss Report (CLR) | 07/01/2022 |
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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