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Download Number Form Name Effective Date
DES-1077A-S Aviso Sobre Las Prácticas de Confidencialidad 09/01/2018
UB-010 Eligibility Review Questionnaire 09/01/2018
DD-191 Incident Report 09/01/2018
UB-010-S Cuestionario para Revisión de Admisibilidad 09/01/2018
FA-225-S Afirmación De Hogares Por Separado 09/01/2018
UB-105 Arizona Initial Claim for Unemployment Insurance 09/01/2018
FA-255 Separate Household Status Statement 09/01/2018
UB-105-S Reclamo Inicial para Seguro por Desempleo en Arizona 09/01/2018
DES-1059A Authorization to Release Information 09/01/2018
DES-1077A Notice of Privacy Practices 09/01/2018

Download Number Form Name Effective Date
Family Support Program 2019 DDD Family Support Program Annual Report 2019 09/27/2019
GCBVI 2019 Governor's Council in Blindness and Visual Impairment (GCBVI) Annual Report for SFY 2019 10/03/2019
Statistical Bulletin April 2018 Statistical Bulletin April 2018 10/15/2019
Statistical Bulletin September 2019 Statistical Bulletin September 2019 10/30/2019
30th Month August 2019 30th Month Financial Report FY 2019 through August 2019 11/05/2019
30th Month September 2019 30th Month Financial Report FY 2019 through September 2019 11/05/2019
Statistical Bulletin October 2019 Statistical Bulletin October 2019 12/02/2019
TANF Report October 2017 TANF State Plan Effective October 1, 2017 12/05/2019
AZ State Plan - TEFAP 2019-2020 Arizona State Plan - The Emergency Food Assistance Program 2019-2020 12/06/2019

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